DENA L MCCORMICK 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

DENA

Middle

Last Name

MCCORMICK

Business Name

DENA L MCCORMICK

Original Issue Date

01/03/2005

Effective Date

02/03/2024

Expiration Date

03/01/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

12/03/2025