STEPHEN MATTHEW BROADDUS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

ACTIVE

Business

First Name

STEPHEN

Middle

MATTHEW

Last Name

BROADDUS

Business Name

STEPHEN MATTHEW BROADDUS

Original Issue Date

01/12/2015

Effective Date

02/12/2024

Expiration Date

03/01/2026

City

TROY

State

Zip

62294

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025