MADELINE ROSE LARSEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

ACTIVE

Business

First Name

MADELINE

Middle

ROSE

Last Name

LARSEN

Business Name

MADELINE ROSE LARSEN

Original Issue Date

08/16/2022

Effective Date

03/04/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60654

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026