KELSEY BRIANNE WICKENHAUSER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005018

License Status

ACTIVE

Business

First Name

KELSEY

Middle

BRIANNE

Last Name

WICKENHAUSER

Business Name

KELSEY BRIANNE WICKENHAUSER

Original Issue Date

03/26/2014

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

02/06/2026