DESTINY GRACE PETROWICH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

ACTIVE

Business

First Name

DESTINY

Middle

GRACE

Last Name

PETROWICH

Business Name

DESTINY GRACE PETROWICH

Original Issue Date

10/27/2020

Effective Date

02/26/2026

Expiration Date

03/01/2028

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/26/2026