SCOTT JOSEPH CICCIARELLI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

ACTIVE

Business

First Name

SCOTT

Middle

JOSEPH

Last Name

CICCIARELLI

Business Name

SCOTT JOSEPH CICCIARELLI

Original Issue Date

08/16/2022

Effective Date

02/03/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2026