SOPHIA HOPE KANNENBERG O'BRYAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

ACTIVE

Business

First Name

SOPHIA

Middle

HOPE KANNENBERG

Last Name

O'BRYAN

Business Name

SOPHIA HOPE KANNENBERG O'BRYAN

Original Issue Date

11/27/2018

Effective Date

01/15/2026

Expiration Date

03/01/2028

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/15/2026