MADELEINE GRACE SUBACH Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****14

License Status

INOPERATIVE

Business

First Name

MADELEINE

Middle

GRACE

Last Name

SUBACH

Business Name

MADELEINE GRACE SUBACH

Original Issue Date

07/09/2025

Effective Date

07/09/2025

Expiration Date

03/01/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/03/2025