MARIO MICHAEL MISSEHA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

NOT RENEWED

Business

First Name

MARIO

Middle

MICHAEL

Last Name

MISSEHA

Business Name

MARIO MICHAEL MISSEHA

Original Issue Date

06/23/2022

Effective Date

06/23/2022

Expiration Date

03/01/2024

City

AURORA

State

Zip

60504

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025