KATELYN ELIZABETH BENNETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

NOT RENEWED

Business

First Name

KATELYN

Middle

ELIZABETH

Last Name

BENNETT

Business Name

KATELYN ELIZABETH BENNETT

Original Issue Date

10/27/2008

Effective Date

01/27/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60643

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016