BRENNAN ROBERT MALHAM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

ACTIVE

Business

First Name

BRENNAN

Middle

ROBERT

Last Name

MALHAM

Business Name

BRENNAN ROBERT MALHAM

Original Issue Date

10/27/2016

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025