MADELYN NICOLE KUSSMANN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

NOT RENEWED

Business

First Name

MADELYN

Middle

NICOLE

Last Name

KUSSMANN

Business Name

MADELYN NICOLE KUSSMANN

Original Issue Date

01/27/2020

Effective Date

01/27/2020

Expiration Date

03/01/2022

City

ELDRIDGE

State

Zip

52748

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022