SCOTT ALAN SOUTHERLAND Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

ACTIVE

Business

First Name

SCOTT

Middle

ALAN

Last Name

SOUTHERLAND

Business Name

SCOTT ALAN SOUTHERLAND

Original Issue Date

10/03/2016

Effective Date

01/14/2026

Expiration Date

03/01/2028

City

URBANA

State

Zip

61801

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2026