MATTHEW WAGGONER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010341

License Status

ACTIVE

Business

First Name

MATTHEW

Last Name

WAGGONER

Business Name

MATTHEW WAGGONER

Original Issue Date

02/03/2024

Effective Date

01/26/2026

Expiration Date

03/01/2028

City

DUNDEE

State

Zip

48131

Ever Disciplined

LastModifiedDate

01/26/2026