CHELSEA NICOLE LAGRANGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

NOT RENEWED

Business

First Name

CHELSEA

Middle

NICOLE

Last Name

LAGRANGE

Business Name

CHELSEA NICOLE LAGRANGE

Original Issue Date

09/23/2015

Effective Date

01/12/2022

Expiration Date

03/01/2024

City

CHAMPAIGN

State

Zip

61874

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025