HARRISON J SWALLA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****99

License Status

ACTIVE

Business

First Name

HARRISON

Middle

Last Name

SWALLA

Business Name

HARRISON J SWALLA

Original Issue Date

11/07/2022

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

ROCHELLE

State

Zip

61068

County

OGLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026