EMILY N SHAW Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

INOPERATIVE

Business

First Name

EMILY

Middle

Last Name

SHAW

Business Name

EMILY N SHAW

Original Issue Date

01/05/2004

Effective Date

02/20/2018

Expiration Date

03/01/2020

City

BATAVIA

State

Zip

60510

County

KANE

Ever Disciplined

LastModifiedDate

12/18/2019