MADELINE M MANDOZA 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

MADELINE

Middle

Last Name

MANDOZA

Business Name

MADELINE M MANDOZA

Original Issue Date

10/17/2024

Effective Date

02/05/2026

Expiration Date

03/01/2028

City

CAROL STREAM

State

Zip

60188

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2026