KATHERINE GWEN THOMPSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****20

License Status

NOT RENEWED

Business

First Name

KATHERINE

Middle

GWEN

Last Name

THOMPSON

Business Name

KATHERINE GWEN THOMPSON

Original Issue Date

04/23/2003

Effective Date

04/23/2003

Expiration Date

03/01/2006

City

PALATINE

State

Zip

60067

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006