MIA KEHOE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****24

License Status

NOT RENEWED

Business

First Name

MIA

Last Name

KEHOE

Business Name

MIA KEHOE

Original Issue Date

10/30/2018

Effective Date

01/06/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022