ZACHARY ALAN HATHWAY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

ACTIVE

Business

First Name

ZACHARY

Middle

ALAN

Last Name

HATHWAY

Business Name

ZACHARY ALAN HATHWAY

Original Issue Date

07/20/2016

Effective Date

01/28/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/28/2026