KORI LYNN CARROLL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

ACTIVE

Business

First Name

KORI

Middle

LYNN

Last Name

CARROLL

Business Name

KORI LYNN CARROLL

Original Issue Date

03/23/2001

Effective Date

12/09/2025

Expiration Date

03/01/2028

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/09/2025