JOHN R SODERSTROM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****26

License Status

ACTIVE

Business

First Name

JOHN

Middle

Last Name

SODERSTROM

Business Name

JOHN R SODERSTROM

Original Issue Date

10/12/2006

Effective Date

01/13/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/13/2026