KATHARINE AMANDA TJADEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

NOT RENEWED

Business

First Name

KATHARINE

Middle

AMANDA

Last Name

TJADEN

Business Name

KATHARINE AMANDA TJADEN

Original Issue Date

07/29/2021

Effective Date

01/25/2022

Expiration Date

03/01/2024

City

DANVILLE

State

Zip

61832

County

VERMILION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025