JEREMY ADAM HOUTAKKER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003045

License Status

ACTIVE

Business

First Name

JEREMY

Middle

ADAM

Last Name

HOUTAKKER

Business Name

JEREMY ADAM HOUTAKKER

Original Issue Date

09/17/2007

Effective Date

12/12/2025

Expiration Date

03/01/2028

City

GENOA CITY

State

Zip

53128

County

WISCONSIN

Ever Disciplined

LastModifiedDate

12/12/2025