DEANNE CLELIA FORNELLI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

ACTIVE

Business

First Name

DEANNE

Middle

CLELIA

Last Name

FORNELLI

Business Name

DEANNE CLELIA FORNELLI

Original Issue Date

12/20/2010

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60612

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025