ADAM MICHAEL WENNERSTEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

ACTIVE

Business

First Name

ADAM

Middle

MICHAEL

Last Name

WENNERSTEN

Business Name

ADAM MICHAEL WENNERSTEN

Original Issue Date

09/27/2023

Effective Date

02/06/2024

Expiration Date

03/01/2026

City

RAYMOND

State

Zip

62560

County

MONTGOMERY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025