KELLY KRISTINE CUNNINGHAM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

ACTIVE

Business

First Name

KELLY

Middle

KRISTINE

Last Name

CUNNINGHAM

Business Name

KELLY KRISTINE CUNNINGHAM

Original Issue Date

07/28/2020

Effective Date

12/12/2023

Expiration Date

03/01/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025