BRIAN NEAL SHORE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****37

License Status

ACTIVE

Business

First Name

BRIAN

Middle

NEAL

Last Name

SHORE

Business Name

BRIAN NEAL SHORE

Original Issue Date

06/09/2006

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026