MARK T SHIELS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072619

License Status

INACTIVE

Business

First Name

MARK T

Last Name

SHIELS

Suffix

Business Name

MARK T SHIELS MD

Original Issue Date

04/21/1986

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/12/2017