JUSTIN MICHAEL KOEHL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

ACTIVE

Business

First Name

JUSTIN

Middle

MICHAEL

Last Name

KOEHL

Business Name

JUSTIN MICHAEL KOEHL

Original Issue Date

03/21/2018

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025