ANNALYSE GRACE FAULK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

ACTIVE

Business

First Name

ANNALYSE

Middle

GRACE

Last Name

FAULK

Business Name

ANNALYSE GRACE FAULK

Original Issue Date

02/09/2021

Effective Date

02/22/2024

Expiration Date

03/01/2026

City

CHICAGO

State

Zip

60623

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025