KEVIN MICHAEL WIDDIS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008551

License Status

ACTIVE

Business

First Name

KEVIN

Middle

MICHAEL

Last Name

WIDDIS

Business Name

KEVIN MICHAEL WIDDIS

Original Issue Date

08/21/2021

Effective Date

12/17/2025

Expiration Date

03/01/2028

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/17/2025