MIMI HARZAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****13

License Status

ACTIVE

Business

First Name

MIMI

Last Name

HARZAN

Business Name

MIMI HARZAN

Original Issue Date

10/21/2021

Effective Date

12/06/2023

Expiration Date

03/01/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025