REBECCA JEAN ULTCH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****09

License Status

ACTIVE

Business

First Name

REBECCA

Middle

JEAN

Last Name

ULTCH

Business Name

REBECCA JEAN ULTCH

Original Issue Date

06/03/2004

Effective Date

02/19/2026

Expiration Date

03/01/2028

City

HOPEDALE

State

Zip

61747

County

TAZEWELL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/19/2026