KRISTY MARIE MACELLAIO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

ACTIVE

Business

First Name

KRISTY

Middle

MARIE

Last Name

MACELLAIO

Business Name

KRISTY MARIE MACELLAIO

Original Issue Date

12/31/2002

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

AURORA

State

Zip

60504

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025