RACHEL LEE FREDERICKSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

NOT RENEWED

Business

First Name

RACHEL

Middle

LEE

Last Name

FREDERICKSON

Business Name

RACHEL LEE FREDERICKSON

Original Issue Date

01/30/2003

Effective Date

12/30/2009

Expiration Date

03/01/2012

City

WOODSTOCK

State

Zip

60098

County

MCHENRY

Ever Disciplined

LastModifiedDate

04/16/2012