MCKENNA ELLISE BLACK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085011527

License Status

ACTIVE

Business

First Name

MCKENNA

Middle

ELLISE

Last Name

BLACK

Business Name

MCKENNA ELLISE BLACK

Original Issue Date

08/06/2025

Effective Date

02/04/2026

Expiration Date

03/01/2028

City

COLUMBUS

State

Zip

43221

Ever Disciplined

LastModifiedDate

02/04/2026