MICHAEL SHANE HENNESY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131157

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

SHANE

Last Name

HENNESY

Business Name

MICHAEL SHANE HENNESY MD

Original Issue Date

08/14/2012

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/20/2023