SHANNON L TRUNK BROKOP Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000761

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

TRUNK BROKOP

Business Name

SHANNON L TRUNK BROKOP

Original Issue Date

02/07/1996

Effective Date

02/09/2026

Expiration Date

03/01/2028

City

DEMOTTE

State

Zip

46310

County

KANKAKEE

Ever Disciplined

LastModifiedDate

02/09/2026