KATHLEEN ELIZABETH KLECKNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

ELIZABETH

Last Name

KLECKNER

Business Name

KATHLEEN ELIZABETH KLECKNER

Original Issue Date

11/04/2010

Effective Date

03/02/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014