JASON KENNETH MANTHEI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

ACTIVE

Business

First Name

JASON

Middle

KENNETH

Last Name

MANTHEI

Business Name

JASON KENNETH MANTHEI

Original Issue Date

12/22/2004

Effective Date

12/16/2025

Expiration Date

03/01/2028

City

GILLESPIE

State

Zip

62033

County

MACOUPIN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/16/2025