GRACE ROTHSTEIN IMMEL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

INOPERATIVE

Business

First Name

GRACE

Middle

ROTHSTEIN

Last Name

IMMEL

Business Name

GRACE ROTHSTEIN IMMEL

Original Issue Date

08/25/2020

Effective Date

02/17/2022

Expiration Date

03/01/2024

City

LYONS

State

Zip

60534

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2023