KATRINA JAMES DE SHANEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

NOT RENEWED

Business

First Name

KATRINA

Middle

JAMES

Last Name

DE SHANEY

Business Name

KATRINA JAMES DE SHANEY

Original Issue Date

08/10/2012

Effective Date

02/20/2018

Expiration Date

03/01/2020

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020