KATHERINE D KETTERHAGEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****16

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

Last Name

KETTERHAGEN

Business Name

KATHERINE D KETTERHAGEN

Original Issue Date

03/25/2008

Effective Date

02/25/2010

Expiration Date

03/01/2012

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

03/13/2013