KATIE LYNN GROSS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****40

License Status

INOPERATIVE

Business

First Name

KATIE

Middle

LYNN

Last Name

GROSS

Business Name

KATIE LYNN GROSS

Original Issue Date

08/09/2012

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019