JEREMY R SHAPIRO DO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003309

License Status

NOT RENEWED

Business

Title

First Name

JEREMY

Middle

Last Name

SHAPIRO

Business Name

JEREMY R SHAPIRO DO

Original Issue Date

09/16/2008

Effective Date

02/16/2016

Expiration Date

03/01/2018

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

04/02/2019