MEGAN MAE PENFOLD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****90

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

MAE

Last Name

PENFOLD

Business Name

MEGAN MAE PENFOLD

Original Issue Date

12/12/2008

Effective Date

01/22/2010

Expiration Date

03/01/2012

City

GLENVIEW

State

Zip

60026

County

COOK

Ever Disciplined

LastModifiedDate

01/02/2015