KATHERINE ANNE GOODRICH Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****85

License Status

INOPERATIVE

Business

First Name

KATHERINE

Middle

ANNE

Last Name

GOODRICH

Business Name

KATHERINE ANNE GOODRICH

Original Issue Date

04/03/2012

Effective Date

01/30/2014

Expiration Date

03/01/2016

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

10/02/2014