MALLORY JEAN HENSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

ACTIVE

Business

First Name

MALLORY

Middle

JEAN

Last Name

HENSON

Business Name

MALLORY JEAN HENSON

Original Issue Date

10/23/2020

Effective Date

02/17/2026

Expiration Date

03/01/2028

City

MARYVILLE

State

Zip

62062

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/17/2026