KATHERINE ANNE GOODRICH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004311

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

ANNE

Last Name

GOODRICH

Business Name

KATHERINE ANNE GOODRICH

Original Issue Date

04/03/2012

Effective Date

01/30/2014

Expiration Date

03/01/2016

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016