JENNIFER L GRACE 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

JENNIFER

Middle

Last Name

GRACE

Business Name

JENNIFER L GRACE

Original Issue Date

03/15/2012

Effective Date

03/15/2012

Expiration Date

03/01/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014