MIA MCKENZIE WALTERS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011639

License Status

ACTIVE

Business

First Name

MIA

Middle

MCKENZIE

Last Name

WALTERS

Business Name

MIA MCKENZIE WALTERS

Original Issue Date

09/03/2025

Effective Date

09/03/2025

Expiration Date

03/01/2026

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

12/03/2025