ANNA K ELLERBROEK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****20

License Status

ACTIVE

Business

First Name

ANNA

Middle

Last Name

ELLERBROEK

Business Name

ANNA K ELLERBROEK

Original Issue Date

10/25/2005

Effective Date

12/08/2025

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/08/2025