KATHARINE AMANDA TJADEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008202

License Status

NOT RENEWED

Business

First Name

KATHARINE

Middle

AMANDA

Last Name

TJADEN

Business Name

KATHARINE AMANDA TJADEN

Original Issue Date

02/08/2021

Effective Date

01/19/2022

Expiration Date

03/01/2024

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

02/05/2025