SHANNON RAE MCCORMICK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****76

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

RAE

Last Name

MCCORMICK

Business Name

SHANNON RAE MCCORMICK

Original Issue Date

12/31/2002

Effective Date

02/05/2008

Expiration Date

03/01/2010

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/17/2018