GRACE ANNE GOLAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

NOT RENEWED

Business

First Name

GRACE

Middle

ANNE

Last Name

GOLAN

Business Name

GRACE ANNE GOLAN

Original Issue Date

03/08/2016

Effective Date

02/04/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022