EMILY ARLENE GRACE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****93

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

ARLENE

Last Name

GRACE

Business Name

EMILY ARLENE GRACE

Original Issue Date

10/31/2016

Effective Date

01/13/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60647

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025