GRACE W CHAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003356

License Status

NOT RENEWED

Business

First Name

GRACE W

Last Name

CHAN

Business Name

GRACE W CHAN

Original Issue Date

10/14/2008

Effective Date

03/03/2020

Expiration Date

03/01/2022

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022