ORIE R POTTER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

ACTIVE

Business

First Name

ORIE

Middle

Last Name

POTTER

Business Name

ORIE R POTTER

Original Issue Date

04/13/2001

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

MONMOUTH

State

Zip

61462

County

WARREN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026