DECLAN G SHEPPARD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098091

License Status

NOT RENEWED

Business

First Name

DECLAN

Middle

Last Name

SHEPPARD

Business Name

DECLAN G SHEPPARD

Original Issue Date

06/26/1998

Effective Date

06/26/1998

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006