JACOB BAYLEY SHOLL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

ACTIVE

Business

First Name

JACOB

Middle

BAYLEY

Last Name

SHOLL

Business Name

JACOB BAYLEY SHOLL

Original Issue Date

09/25/2024

Effective Date

02/04/2026

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2026