SHANNON R MAHONEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002384

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

MAHONEY

Business Name

SHANNON R MAHONEY

Original Issue Date

10/14/2004

Effective Date

02/24/2010

Expiration Date

03/01/2012

City

SAN DIEGO

State

Zip

92109

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

04/11/2012