MADISON CAROL MEDINA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****11

License Status

ACTIVE

Business

First Name

MADISON

Middle

CAROL

Last Name

MEDINA

Business Name

MADISON CAROL MEDINA

Original Issue Date

02/11/2025

Effective Date

01/07/2026

Expiration Date

03/01/2028

City

ORLAND PARK

State

Zip

60462

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/07/2026