MATTHEW WAGGONER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

ACTIVE

Business

First Name

MATTHEW

Last Name

WAGGONER

Business Name

MATTHEW WAGGONER

Original Issue Date

08/21/2025

Effective Date

01/26/2026

Expiration Date

03/01/2028

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/26/2026