ALIYAH J MANGRUM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008132

License Status

ACTIVE

Business

First Name

ALIYAH

Middle

Last Name

MANGRUM

Business Name

ALIYAH J MANGRUM

Original Issue Date

01/15/2021

Effective Date

01/19/2026

Expiration Date

03/01/2028

City

WASHINGTON

State

Zip

20003

County

DISTRICT OF COLUMBIA

Ever Disciplined

LastModifiedDate

01/19/2026