MAMTA RANI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****63

License Status

ACTIVE

Business

First Name

MAMTA

Last Name

RANI

Business Name

MAMTA RANI

Original Issue Date

03/04/2004

Effective Date

12/26/2025

Expiration Date

03/01/2028

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

12/26/2025