MEREDITH C H WOTKA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****25

License Status

INOPERATIVE

Business

First Name

MEREDITH

Middle

C H

Last Name

WOTKA

Business Name

MEREDITH C H WOTKA

Original Issue Date

03/16/2018

Effective Date

03/16/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019