JERRY PRIDDY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****68

License Status

ACTIVE

Business

First Name

JERRY

Last Name

PRIDDY

Business Name

JERRY PRIDDY

Original Issue Date

04/10/2017

Effective Date

01/08/2026

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/08/2026