SHANNON M PORTER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****09

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

PORTER

Business Name

SHANNON M PORTER

Original Issue Date

03/18/2002

Effective Date

03/18/2002

Expiration Date

03/01/2004

City

PALATINE

State

Zip

60067

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006