MACKENZIE RAE GOLUB Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

NOT RENEWED

Business

First Name

MACKENZIE

Middle

RAE

Last Name

GOLUB

Business Name

MACKENZIE RAE GOLUB

Original Issue Date

09/24/2022

Effective Date

09/24/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025