LARRY KEITH WHITAKER JR Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002299

License Status

ACTIVE

Business

First Name

LARRY

Middle

KEITH

Last Name

WHITAKER

Suffix

Business Name

LARRY KEITH WHITAKER JR

Original Issue Date

08/20/2004

Effective Date

01/21/2026

Expiration Date

03/01/2028

City

HOOPESTON

State

Zip

60942

County

VERMILION

Ever Disciplined

LastModifiedDate

01/21/2026