ANDREA FOUNTAIN BRILES Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

ACTIVE

Business

First Name

ANDREA

Middle

FOUNTAIN

Last Name

BRILES

Business Name

ANDREA FOUNTAIN BRILES

Original Issue Date

10/19/2012

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Delegated Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

02/02/2026