KATHLEEN JOYCE MITCHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

JOYCE

Last Name

MITCHAM

Business Name

KATHLEEN JOYCE MITCHAM

Original Issue Date

07/26/2006

Effective Date

07/26/2006

Expiration Date

03/01/2008

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Ever Disciplined

LastModifiedDate

01/25/2007