DIANE COLES Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

ACTIVE

Business

First Name

DIANE

Last Name

COLES

Business Name

DIANE COLES

Original Issue Date

01/12/2021

Effective Date

01/21/2026

Expiration Date

03/01/2028

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/21/2026