KAYLA RENE VANDERWALL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****84

License Status

NOT RENEWED

Business

First Name

KAYLA

Middle

RENE

Last Name

VANDERWALL

Business Name

KAYLA RENE VANDERWALL

Original Issue Date

11/16/2019

Effective Date

01/22/2022

Expiration Date

03/01/2024

City

ELMHURST

State

Zip

60126

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025