JEFFREY BENJAMIN MIESSAU Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****53

License Status

ACTIVE

Business

First Name

JEFFREY

Middle

BENJAMIN

Last Name

MIESSAU

Business Name

JEFFREY BENJAMIN MIESSAU

Original Issue Date

06/11/2019

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

12/03/2025