CLARK F ANDERSON II 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

CLARK

Middle

Last Name

ANDERSON

Suffix

Business Name

CLARK F ANDERSON II

Original Issue Date

09/14/2006

Effective Date

02/22/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/22/2026