MIRANDA KRISTINE CARRICO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

ACTIVE

Business

First Name

MIRANDA

Middle

KRISTINE

Last Name

CARRICO

Business Name

MIRANDA KRISTINE CARRICO

Original Issue Date

04/16/2012

Effective Date

12/12/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/12/2025