SHATARA D DAVIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005867

License Status

NOT RENEWED

Business

First Name

SHATARA

Middle

Last Name

DAVIS

Business Name

SHATARA D DAVIS

Original Issue Date

07/01/2016

Effective Date

02/18/2020

Expiration Date

03/01/2022

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

07/27/2022