SHOSHANA B CHURCH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002122

License Status

ACTIVE

Business

First Name

SHOSHANA

Middle

Last Name

CHURCH

Business Name

SHOSHANA B CHURCH

Original Issue Date

10/15/2003

Effective Date

02/06/2026

Expiration Date

03/01/2028

City

MARION

State

Zip

62959

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

02/06/2026