JEFFREY D JOHNSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

ACTIVE

Business

First Name

JEFFREY

Middle

Last Name

JOHNSON

Business Name

JEFFREY D JOHNSON

Original Issue Date

11/05/2015

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025