AUDREY ELIZABETH FENWICK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

NOT RENEWED

Business

First Name

AUDREY

Middle

ELIZABETH

Last Name

FENWICK

Business Name

AUDREY ELIZABETH FENWICK

Original Issue Date

08/23/2018

Effective Date

01/11/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60611

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025