ROBERT J MONTGOMERY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006719

License Status

ACTIVE

Business

First Name

ROBERT

Middle

Last Name

MONTGOMERY

Business Name

ROBERT J MONTGOMERY

Original Issue Date

08/23/2018

Effective Date

02/28/2026

Expiration Date

03/01/2028

City

NEW HAVEN

State

Zip

63068

Ever Disciplined

LastModifiedDate

02/28/2026

Case Number

2021011334

Action

Suspension

Discipline Start Date

02/22/2022

Discipline End Date

04/14/2022

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 04/15/2022.