SUZANNE MARIE SHIMAITIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

SUZANNE

Middle

MARIE

Last Name

SHIMAITIS

Business Name

SUZANNE MARIE SHIMAITIS

Original Issue Date

12/12/2006

Effective Date

01/06/2020

Expiration Date

03/01/2022

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022