TRACEE ANGELA BLACKBURN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002507

License Status

ACTIVE

Business

First Name

TRACEE

Middle

ANGELA

Last Name

BLACKBURN

Business Name

TRACEE ANGELA BLACKBURN

Original Issue Date

07/21/2005

Effective Date

02/10/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

02/10/2026