SIMON PETER SHAFFER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003662

License Status

NOT RENEWED

Business

First Name

SIMON

Middle

PETER

Last Name

SHAFFER

Business Name

SIMON PETER SHAFFER

Original Issue Date

11/05/2009

Effective Date

04/21/2010

Expiration Date

03/01/2012

City

WAKE FOREST

State

Zip

27587

County

NORTH CAROLINA

Ever Disciplined

LastModifiedDate

04/11/2012