KASEY KETRINA SWAFFORD-FORREST Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

NOT RENEWED

Business

First Name

KASEY

Middle

KETRINA

Last Name

SWAFFORD-FORREST

Business Name

KASEY KETRINA SWAFFORD-FORREST

Original Issue Date

02/01/2018

Effective Date

02/01/2018

Expiration Date

03/01/2020

City

BERWYN

State

Zip

60402

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020