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Shelby
Shelby
Lane
Physician assistant
President
Fort Lauderdale, United States
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Florida Board of Medicine
Board Name
BOARD OF MEDICINE
Full name
Shelby Lane
Job Title
Physician Assistant
Qualifications
Prescribing
License Number
PA9106913
License Status
Clear/Active
License Issue Date
04/10/2012
License Expiry Date
31/01/2026
Source Type
Professional Profile
Florida Health Care Practitioner Data Portal
Full name
SHELBY LANE
Job Title
Physician Assistant
Location
Fort Lauderdale, FL, USA
LIC ID
9748
Current License Expiration Date
31/01/2026
Original Date
04/10/2012
Professional Rank Code
PA
Effective Date
04/10/2012
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
BROWARD
Practice Location Address Line 1
3319 NE 15th Court
Practice Location Address City
FORT LAUDERDALE
Practice Location Address State
FL
Practice Location Address Zipcode
33304
Mode Code
Prescribing
Prescribing Indicator
N
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