BRENNA LAUREN HENNESSEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

NOT RENEWED

Business

First Name

BRENNA

Middle

LAUREN

Last Name

HENNESSEY

Business Name

BRENNA LAUREN HENNESSEY

Original Issue Date

09/14/2018

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022