JENNIFER LEE WHALEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

LEE

Last Name

WHALEN

Business Name

JENNIFER LEE WHALEN

Original Issue Date

04/14/2005

Effective Date

04/14/2005

Expiration Date

03/01/2008

City

MANTENO

State

Zip

60950

County

KANKAKEE

Ever Disciplined

LastModifiedDate

09/26/2006