SHANA BEAVER FEARNLEY PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001566

License Status

NOT RENEWED

Business

First Name

SHANA

Middle

BEAVER

Last Name

FEARNLEY

Suffix

PA-C

Business Name

SHANA BEAVER FEARNLEY PA-C

Original Issue Date

03/15/2001

Effective Date

03/15/2001

Expiration Date

03/01/2004

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006