ERIN KATHLEEN MELLEY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

INOPERATIVE

Business

First Name

ERIN

Middle

KATHLEEN

Last Name

MELLEY

Business Name

ERIN KATHLEEN MELLEY

Original Issue Date

05/10/2002

Effective Date

01/31/2022

Expiration Date

03/01/2024

City

SKOKIE

State

Zip

60077

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2023