MACKENZIE N SHALLENBERGER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004155

License Status

ACTIVE

Business

First Name

MACKENZIE

Middle

Last Name

SHALLENBERGER

Business Name

MACKENZIE N SHALLENBERGER

Original Issue Date

09/26/2011

Effective Date

12/17/2025

Expiration Date

03/01/2028

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

12/17/2025