KENNETH RICHARDS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

INOPERATIVE

Business

First Name

KENNETH

Last Name

RICHARDS

Business Name

KENNETH RICHARDS

Original Issue Date

04/01/2019

Effective Date

04/01/2019

Expiration Date

03/01/2020

City

ITASCA

State

Zip

60143

County

DUPAGE

Ever Disciplined

LastModifiedDate

12/18/2019