MIKAELA LEE DOMICO 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

MIKAELA

Middle

LEE

Last Name

DOMICO

Business Name

MIKAELA LEE DOMICO

Original Issue Date

09/09/2025

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

GENEVA

State

Zip

60134

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/22/2026