SIMON PETER SHAFFER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****62

License Status

NOT RENEWED

Business

First Name

SIMON

Middle

PETER

Last Name

SHAFFER

Business Name

SIMON PETER SHAFFER

Original Issue Date

01/14/2010

Effective Date

01/14/2010

Expiration Date

03/01/2012

City

BEARDSTOWN

State

Zip

62618

County

CASS

Ever Disciplined

LastModifiedDate

04/16/2012