LARRY KEITH WHITAKER JR Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

ACTIVE

Business

First Name

LARRY

Middle

KEITH

Last Name

WHITAKER

Suffix

Business Name

LARRY KEITH WHITAKER JR

Original Issue Date

01/20/2005

Effective Date

01/21/2026

Expiration Date

03/01/2028

City

HOOPESTON

State

Zip

60942

County

VERMILION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/21/2026