JAMES R MANGERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****19

License Status

ACTIVE

Business

First Name

JAMES

Middle

Last Name

MANGERSON

Business Name

JAMES R MANGERSON

Original Issue Date

02/19/2025

Effective Date

02/10/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

02/10/2026