LEROY SHOUSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123179

License Status

NOT RENEWED

Business

First Name

LEROY

Last Name

SHOUSE

Suffix

Business Name

LEROY SHOUSE MD

Original Issue Date

04/15/2009

Effective Date

03/30/2012

Expiration Date

07/31/2014

City

HUDSON

State

Zip

61748

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/17/2014