JEONGWON SHIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141899

License Status

NOT RENEWED

Business

Title

First Name

JEONGWON

Last Name

SHIN

Business Name

JEONGWON SHIN MD

Original Issue Date

10/26/2016

Effective Date

10/26/2016

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61636

County

PEORIA

Ever Disciplined

LastModifiedDate

11/01/2017