SHANNON N SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****68

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

Last Name

SMITH

Business Name

SHANNON N SMITH

Original Issue Date

01/29/2010

Effective Date

01/29/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

12/15/2017