MICHAELA E RICKERT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****05

License Status

NOT RENEWED

Business

First Name

MICHAELA

Middle

Last Name

RICKERT

Business Name

MICHAELA E RICKERT

Original Issue Date

11/03/2014

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/24/2020