GRACE PETR 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

PETR

Business Name

GRACE PETR

Original Issue Date

01/29/2024

Effective Date

01/08/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/08/2026