ANGELA DAWN POBLOCKI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****15

License Status

ACTIVE

Business

First Name

ANGELA

Middle

DAWN

Last Name

POBLOCKI

Business Name

ANGELA DAWN POBLOCKI

Original Issue Date

06/25/2024

Effective Date

01/12/2026

Expiration Date

03/01/2028

City

BARTONVILLE

State

Zip

61607

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/12/2026