BECKY LYNN JARACZ KOHL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

NOT RENEWED

Business

First Name

BECKY

Middle

LYNN JARACZ

Last Name

KOHL

Business Name

BECKY LYNN JARACZ KOHL

Original Issue Date

02/05/2002

Effective Date

02/05/2002

Expiration Date

03/01/2006

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006