RICKY DAVID SHAPIRO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****74

License Status

ACTIVE

Business

First Name

RICKY

Middle

DAVID

Last Name

SHAPIRO

Business Name

RICKY DAVID SHAPIRO

Original Issue Date

10/17/2003

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

DES PLAINES

State

Zip

60016

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025