SHANNON R MAHONEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****14

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

MAHONEY

Business Name

SHANNON R MAHONEY

Original Issue Date

12/23/2004

Effective Date

02/24/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012