SUSAN JANE SHEPPARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101712

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

JANE

Last Name

SHEPPARD

Suffix

Business Name

SUSAN JANE SHEPPARD MD

Original Issue Date

12/15/1999

Effective Date

09/04/2020

Expiration Date

07/31/2023

City

NORMAL

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/30/2023