MCKENZIE K MANGUN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011710

License Status

ACTIVE

Business

First Name

MCKENZIE

Middle

Last Name

MANGUN

Business Name

MCKENZIE K MANGUN

Original Issue Date

10/06/2025

Effective Date

01/13/2026

Expiration Date

03/01/2028

City

ROANOKE

State

Zip

61561

County

WOODFORD

Ever Disciplined

LastModifiedDate

01/13/2026