License Verification

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MCKENZIE CHIOLA

License Number: PA9115632

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9115632
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
02/04/2022
Address of Record
711 North Chew Road
HAMMONTON, NJ 08037
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
711 North Chew Road
HAMMONTON, NJ 08037
Name Relationship Profession License Effective Date
AGBI, ANDREW OMOH Supervising Prescribing Practitioner Osteopathic Physician 10970 04/19/2023
BAKIR, BAYAN Supervising Prescribing Practitioner Medical Doctor 111515 04/21/2022
BAUMGARD, MARC A M D Supervising Prescribing Practitioner Medical Doctor 125761 04/12/2022
HU, DAVID T Supervising Prescribing Practitioner Medical Doctor 90064 01/16/2023
RAJU, SATESH K Supervising Prescribing Practitioner Medical Doctor 99117 04/11/2022

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



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** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


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