LYDIA ESTHER VANNATTA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

ACTIVE

Business

First Name

LYDIA

Middle

ESTHER

Last Name

VANNATTA

Business Name

LYDIA ESTHER VANNATTA

Original Issue Date

07/29/2015

Effective Date

02/02/2026

Expiration Date

03/01/2028

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/02/2026