HEIDI S HENDERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****34

License Status

ACTIVE

Business

First Name

HEIDI

Middle

Last Name

HENDERSON

Business Name

HEIDI S HENDERSON

Original Issue Date

10/24/2006

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61636

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026