DALTON V REA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****47

License Status

ACTIVE

Business

First Name

DALTON

Middle

Last Name

REA

Business Name

DALTON V REA

Original Issue Date

11/07/2024

Effective Date

01/18/2026

Expiration Date

03/01/2028

City

DUNLAP

State

Zip

61525

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/18/2026