DIVINE P. MENGUE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010865

License Status

ACTIVE

Business

First Name

DIVINE

Middle

Last Name

MENGUE

Business Name

DIVINE P. MENGUE

Original Issue Date

10/02/2024

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

ORLAND PARK

State

Zip

60467

Ever Disciplined

LastModifiedDate

02/06/2026