KELSEY L ROBITAILLE 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

KELSEY

Middle

Last Name

ROBITAILLE

Business Name

KELSEY L ROBITAILLE

Original Issue Date

07/01/2016

Effective Date

02/20/2018

Expiration Date

03/01/2020

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020