LAURA K SHAW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104390

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

Last Name

SHAW

Suffix

Business Name

LAURA K SHAW MD

Original Issue Date

03/23/2001

Effective Date

03/23/2001

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/30/2007