KEVIN J WILSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****40

License Status

ACTIVE

Business

First Name

KEVIN

Middle

Last Name

WILSON

Business Name

KEVIN J WILSON

Original Issue Date

05/02/2002

Effective Date

02/08/2024

Expiration Date

03/01/2026

City

CHAMPAIGN

State

Zip

61822

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025