COLLEEN MARY COFFEY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

INOPERATIVE

Business

First Name

COLLEEN

Middle

MARY

Last Name

COFFEY

Business Name

COLLEEN MARY COFFEY

Original Issue Date

11/09/2016

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019