GRACE ELIZABETH PODUCH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011753

License Status

ACTIVE

Business

First Name

GRACE

Middle

ELIZABETH

Last Name

PODUCH

Business Name

GRACE ELIZABETH PODUCH

Original Issue Date

10/16/2025

Effective Date

03/24/2026

Expiration Date

03/01/2028

City

BLOOMINGTON

State

Zip

47408

Ever Disciplined

LastModifiedDate

03/24/2026