KEELY ERIN PEDERSEN 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

KEELY

Middle

ERIN

Last Name

PEDERSEN

Business Name

KEELY ERIN PEDERSEN

Original Issue Date

01/15/2013

Effective Date

12/15/2025

Expiration Date

03/01/2028

City

MCHENRY

State

Zip

60050

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/15/2025