EVERETT LEE SHAW Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004037

License Status

NOT RENEWED

Business

First Name

EVERETT

Middle

LEE

Last Name

SHAW

Business Name

EVERETT LEE SHAW

Original Issue Date

06/01/2011

Effective Date

01/26/2022

Expiration Date

03/01/2024

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

02/05/2025