MCKENZIE DICKSON GREENE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****42

License Status

INOPERATIVE

Business

First Name

MCKENZIE

Middle

DICKSON

Last Name

GREENE

Business Name

MCKENZIE DICKSON GREENE

Original Issue Date

05/17/2019

Effective Date

01/05/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025