SHEPARD JAY GREENE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102067

License Status

NOT RENEWED

Business

First Name

SHEPARD

Middle

JAY

Last Name

GREENE

Suffix

Business Name

SHEPARD JAY GREENE MD

Original Issue Date

03/03/2000

Effective Date

03/03/2000

Expiration Date

07/31/2002

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

10/09/2006