GRACE GORDON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

ACTIVE

Business

First Name

GRACE

Last Name

GORDON

Business Name

GRACE GORDON

Original Issue Date

12/18/2025

Effective Date

12/18/2025

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/18/2025