KYLE PARKE WOODWORTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

NOT RENEWED

Business

First Name

KYLE

Middle

PARKE

Last Name

WOODWORTH

Business Name

KYLE PARKE WOODWORTH

Original Issue Date

10/17/2017

Effective Date

10/17/2017

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018