SHELBY LANE - Physician Assistant License in Indiana | # 085010175

SHELBY LANE

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010175

License Status

NOT RENEWED

Business

N

First Name

SHELBY

Last Name

LANE

Business Name

SHELBY LANE

Original Issue Date

11/08/2023

Effective Date

11/08/2023

Expiration Date

03/01/2024

State

IN

Ever Disciplined

N

LastModifiedDate

02/05/2025