JOSEPH ROGER BONGIORNO 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

JOSEPH

Middle

ROGER

Last Name

BONGIORNO

Business Name

JOSEPH ROGER BONGIORNO

Original Issue Date

04/17/2025

Effective Date

01/14/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2026