KELCY BAI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****25

License Status

NOT RENEWED

Business

First Name

KELCY

Last Name

BAI

Business Name

KELCY BAI

Original Issue Date

04/15/2019

Effective Date

04/15/2019

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020