AMY ROSE HENDERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

ACTIVE

Business

First Name

AMY

Middle

ROSE

Last Name

HENDERSON

Business Name

AMY ROSE HENDERSON

Original Issue Date

10/19/2018

Effective Date

02/25/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/25/2026