BENJAMIN RICHARD TELLIER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

RICHARD

Last Name

TELLIER

Business Name

BENJAMIN RICHARD TELLIER

Original Issue Date

10/18/2019

Effective Date

12/28/2023

Expiration Date

03/01/2026

City

MADISON

State

Zip

53792

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025