EMILY FAY STREET Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011060

License Status

ACTIVE

Business

First Name

EMILY

Middle

FAY

Last Name

STREET

Business Name

EMILY FAY STREET

Original Issue Date

01/14/2025

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

02/06/2026