CARRIE R ANDERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****51

License Status

ACTIVE

Business

First Name

CARRIE

Middle

Last Name

ANDERSON

Business Name

CARRIE R ANDERSON

Original Issue Date

06/06/2025

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/06/2026