KIMBERLY D SHAW Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****05

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

Last Name

SHAW

Business Name

KIMBERLY D SHAW

Original Issue Date

01/07/2009

Effective Date

01/30/2026

Expiration Date

03/01/2028

City

TINLEY PARK

State

Zip

60477

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/30/2026