LILLIAN GRACE SHIVELY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007743

License Status

ACTIVE

Business

First Name

LILLIAN

Middle

GRACE

Last Name

SHIVELY

Business Name

LILLIAN GRACE SHIVELY

Original Issue Date

06/10/2020

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

01/05/2026