SUSAN M SHAW Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098336

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

SHAW

Business Name

SUSAN M SHAW

Original Issue Date

07/16/1998

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

11/01/2017