KRISTIN ROTH BRENNAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****71

License Status

ACTIVE

Business

First Name

KRISTIN

Middle

ROTH

Last Name

BRENNAN

Business Name

KRISTIN ROTH BRENNAN

Original Issue Date

11/08/2023

Effective Date

03/04/2026

Expiration Date

03/01/2028

City

MORTON GROVE

State

Zip

60053

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026