STEFANI MOMICH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

NOT RENEWED

Business

First Name

STEFANI

Last Name

MOMICH

Business Name

STEFANI MOMICH

Original Issue Date

03/10/2021

Effective Date

02/02/2022

Expiration Date

03/01/2024

City

ELGIN

State

Zip

60123

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025