SHIRLEY A DALLMIER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****30

License Status

NOT RENEWED

Business

First Name

SHIRLEY A

Last Name

DALLMIER

Business Name

SHIRLEY A DALLMIER

Original Issue Date

02/15/2001

Effective Date

02/29/2016

Expiration Date

03/01/2018

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

05/10/2018