BENJAMIN HODGES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****33

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Last Name

HODGES

Business Name

BENJAMIN HODGES

Original Issue Date

01/11/2019

Effective Date

12/27/2019

Expiration Date

03/01/2022

City

OCONOMOWOC

State

Zip

53066

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022