AUSTIN GRAHAM KENNEBECK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010783

License Status

ACTIVE

Business

First Name

AUSTIN

Middle

GRAHAM

Last Name

KENNEBECK

Business Name

AUSTIN GRAHAM KENNEBECK

Original Issue Date

09/13/2024

Effective Date

02/04/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/04/2026