TIFFANNY MARY CONNOLLY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****64

License Status

ACTIVE

Business

First Name

TIFFANNY

Middle

MARY

Last Name

CONNOLLY

Business Name

TIFFANNY MARY CONNOLLY

Original Issue Date

09/29/2009

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/06/2026