BROOKE KIMMERLE MADEN Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004394

License Status

INACTIVE

Business

First Name

BROOKE

Middle

KIMMERLE

Last Name

MADEN

Business Name

BROOKE KIMMERLE MADEN

Original Issue Date

08/08/2012

Effective Date

01/15/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

03/24/2016