MAKENZIE LYNN DISERIO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085009196

License Status

ACTIVE

Business

First Name

MAKENZIE

Middle

LYNN

Last Name

DISERIO

Business Name

MAKENZIE LYNN DISERIO

Original Issue Date

08/13/2022

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

01/06/2026