SHANNON N SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003472

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

SMITH

Business Name

SHANNON N SMITH

Original Issue Date

06/16/2009

Effective Date

12/09/2009

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60653

County

COOK

Ever Disciplined

LastModifiedDate

12/15/2017