KALI ANNE SHEPHARD Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

INOPERATIVE

Business

First Name

KALI

Middle

ANNE

Last Name

SHEPHARD

Business Name

KALI ANNE SHEPHARD

Original Issue Date

07/20/2016

Effective Date

03/08/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

12/18/2019