PATRICIA GRACIELA BLACKBURN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005712

License Status

ACTIVE

Business

First Name

PATRICIA

Middle

GRACIELA

Last Name

BLACKBURN

Business Name

PATRICIA GRACIELA BLACKBURN

Original Issue Date

10/16/2015

Effective Date

12/29/2025

Expiration Date

03/01/2028

City

OGLESBY

State

Zip

61348

County

LA SALLE

Ever Disciplined

LastModifiedDate

12/29/2025