MAKENZIE LYNN DISERIO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

ACTIVE

Business

First Name

MAKENZIE

Middle

LYNN

Last Name

DISERIO

Business Name

MAKENZIE LYNN DISERIO

Original Issue Date

10/11/2022

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

ELGIN

State

Zip

60123

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/06/2026