JENNIFER ROSE KING Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

ROSE

Last Name

KING

Business Name

JENNIFER ROSE KING

Original Issue Date

12/17/2020

Effective Date

01/13/2022

Expiration Date

03/01/2024

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025