TAYLOR WAYNE MEDEIROS 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

TAYLOR

Middle

WAYNE

Last Name

MEDEIROS

Business Name

TAYLOR WAYNE MEDEIROS

Original Issue Date

07/01/2021

Effective Date

01/16/2024

Expiration Date

03/01/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025