KATIE LYNN GROSS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004401

License Status

NOT RENEWED

Business

First Name

KATIE

Middle

LYNN

Last Name

GROSS

Business Name

KATIE LYNN GROSS

Original Issue Date

08/09/2012

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020