KELLY LYNN MAGOON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****62

License Status

ACTIVE

Business

First Name

KELLY

Middle

LYNN

Last Name

MAGOON

Business Name

KELLY LYNN MAGOON

Original Issue Date

08/12/2014

Effective Date

01/15/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/15/2026