JEREMY DANIEL BRUNNER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****24

License Status

ACTIVE

Business

First Name

JEREMY

Middle

DANIEL

Last Name

BRUNNER

Business Name

JEREMY DANIEL BRUNNER

Original Issue Date

11/22/2017

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/02/2026