MICAH RYAN TIEGS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

ACTIVE

Business

First Name

MICAH

Middle

RYAN

Last Name

TIEGS

Business Name

MICAH RYAN TIEGS

Original Issue Date

01/14/2014

Effective Date

01/28/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/28/2026