SHAWN E GOUGH FIBKINS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119707

License Status

INACTIVE

Business

Title

First Name

SHAWN

Middle

Last Name

GOUGH FIBKINS

Business Name

SHAWN E GOUGH FIBKINS MD

Original Issue Date

11/16/2007

Effective Date

11/16/2007

Expiration Date

07/31/2008

City

SANTA MONICA

State

Zip

90404

Ever Disciplined

LastModifiedDate

04/17/2008