REBECCA MARY KATH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

ACTIVE

Business

First Name

REBECCA

Middle

MARY

Last Name

KATH

Business Name

REBECCA MARY KATH

Original Issue Date

04/01/2025

Effective Date

01/11/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61637

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/11/2026