ANGELA KATHLEEN VERVOORT Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****02

License Status

INOPERATIVE

Business

First Name

ANGELA

Middle

KATHLEEN

Last Name

VERVOORT

Business Name

ANGELA KATHLEEN VERVOORT

Original Issue Date

02/01/2013

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

NAPERVILLE

State

Zip

60564

County

WILL

Ever Disciplined

LastModifiedDate

12/18/2019