RACHEL SUPPLE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

ACTIVE

Business

First Name

RACHEL

Last Name

SUPPLE

Business Name

RACHEL SUPPLE

Original Issue Date

09/20/2019

Effective Date

12/05/2025

Expiration Date

03/01/2028

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/05/2025