MELANIE CODERRE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****65

License Status

ACTIVE

Business

First Name

MELANIE

Last Name

CODERRE

Business Name

MELANIE CODERRE

Original Issue Date

07/18/2017

Effective Date

12/31/2023

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60616

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025