LEAH ELIZABETH GONNEVILLE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****19

License Status

ACTIVE

Business

First Name

LEAH

Middle

ELIZABETH

Last Name

GONNEVILLE

Business Name

LEAH ELIZABETH GONNEVILLE

Original Issue Date

07/12/2022

Effective Date

02/10/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60628

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/10/2026