LARRY ERNEST GERDOM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004650

License Status

ACTIVE

Business

First Name

LARRY

Middle

ERNEST

Last Name

GERDOM

Business Name

LARRY ERNEST GERDOM

Original Issue Date

04/25/2013

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CISSNA PARK

State

Zip

60924

County

IROQUOIS

Ever Disciplined

LastModifiedDate

12/03/2025