SHANNON VIRGINIA TAYLOR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****60

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

VIRGINIA

Last Name

TAYLOR

Business Name

SHANNON VIRGINIA TAYLOR

Original Issue Date

08/29/2005

Effective Date

02/18/2016

Expiration Date

03/01/2018

State

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2018