KATHLEEN ERIN IDSTEIN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

INOPERATIVE

Business

First Name

KATHLEEN

Middle

ERIN

Last Name

IDSTEIN

Business Name

KATHLEEN ERIN IDSTEIN

Original Issue Date

11/28/2017

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019