SHANNON MARIE GROVES Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

MARIE

Last Name

GROVES

Business Name

SHANNON MARIE GROVES

Original Issue Date

10/05/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

06/23/2010