TAYLOR WEN 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

TAYLOR

Last Name

WEN

Business Name

TAYLOR WEN

Original Issue Date

04/24/2025

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61615

County

ADAMS

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026