KATIE MICHELLE ROSE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008991

License Status

NOT RENEWED

Business

First Name

KATIE

Middle

MICHELLE

Last Name

ROSE

Business Name

KATIE MICHELLE ROSE

Original Issue Date

06/18/2022

Effective Date

06/18/2022

Expiration Date

03/01/2024

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/05/2025