ANNI IBBERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

ACTIVE

Business

First Name

ANNI

Last Name

IBBERSON

Business Name

ANNI IBBERSON

Original Issue Date

10/20/2025

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

CENTRALIA

State

Zip

62801

County

MARION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/06/2026