KIMBERLY ANN GRANT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

ANN

Last Name

GRANT

Business Name

KIMBERLY ANN GRANT

Original Issue Date

03/24/2011

Effective Date

02/11/2022

Expiration Date

03/01/2024

City

OSWEGO

State

Zip

60543

County

KENDALL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2025