KOURTNEY WAGGONER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011941

License Status

ACTIVE

Business

First Name

KOURTNEY

Last Name

WAGGONER

Business Name

KOURTNEY WAGGONER

Original Issue Date

12/01/2025

Effective Date

01/27/2026

Expiration Date

03/01/2028

City

LIVERPOOL

State

Zip

13090

Ever Disciplined

LastModifiedDate

01/27/2026