TIA MARIE CONSOLINO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****27

License Status

ACTIVE

Business

First Name

TIA

Middle

MARIE

Last Name

CONSOLINO

Business Name

TIA MARIE CONSOLINO

Original Issue Date

10/29/2024

Effective Date

12/10/2025

Expiration Date

03/01/2028

City

FRANKFORT

State

Zip

60423

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/10/2025