KATHLEEN M SHAW Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059343

License Status

INACTIVE

Business

First Name

KATHLEEN M

Last Name

SHAW

Business Name

KATHLEEN M SHAW

Original Issue Date

08/27/1979

Effective Date

04/17/2014

Expiration Date

07/31/2017

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

04/12/2017