GRACE W CHAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

INOPERATIVE

Business

First Name

GRACE W

Last Name

CHAN

Business Name

GRACE W CHAN

Original Issue Date

12/12/2008

Effective Date

01/31/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

03/26/2012