MCKENNA ELLISE BLACK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

ACTIVE

Business

First Name

MCKENNA

Middle

ELLISE

Last Name

BLACK

Business Name

MCKENNA ELLISE BLACK

Original Issue Date

08/15/2025

Effective Date

02/04/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60607

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2026