THERESA M HARRELL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****84

License Status

ACTIVE

Business

First Name

THERESA

Middle

Last Name

HARRELL

Business Name

THERESA M HARRELL

Original Issue Date

03/09/2011

Effective Date

02/05/2026

Expiration Date

03/01/2028

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2026