LAURA FRESE KENNEDY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

FRESE

Last Name

KENNEDY

Business Name

LAURA FRESE KENNEDY

Original Issue Date

08/16/2016

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60613

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022