RACHAEL LEE SUDDARTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****14

License Status

NOT RENEWED

Business

First Name

RACHAEL

Middle

LEE

Last Name

SUDDARTH

Business Name

RACHAEL LEE SUDDARTH

Original Issue Date

09/21/2015

Effective Date

01/07/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022