AUDREY ELIZABETH FENWICK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006630

License Status

NOT RENEWED

Business

First Name

AUDREY

Middle

ELIZABETH

Last Name

FENWICK

Business Name

AUDREY ELIZABETH FENWICK

Original Issue Date

07/13/2018

Effective Date

01/04/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

02/05/2025