LEA M GINDVILLE 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

LEA

Middle

Last Name

GINDVILLE

Business Name

LEA M GINDVILLE

Original Issue Date

02/15/2023

Effective Date

12/10/2025

Expiration Date

03/01/2028

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/10/2025