MEKENNA FREDERICK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011483

License Status

ACTIVE

Business

First Name

MEKENNA

Last Name

FREDERICK

Business Name

MEKENNA FREDERICK

Original Issue Date

07/31/2025

Effective Date

12/15/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60660

County

COOK

Ever Disciplined

LastModifiedDate

12/15/2025