SHEA NICOLE PARKER 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

SHEA

Middle

NICOLE

Last Name

PARKER

Business Name

SHEA NICOLE PARKER

Original Issue Date

07/30/2013

Effective Date

02/04/2016

Expiration Date

03/01/2018

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018