SHADY HENIEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151656

License Status

NOT RENEWED

Business

First Name

SHADY

Last Name

HENIEN

Business Name

SHADY HENIEN

Original Issue Date

01/27/2020

Effective Date

09/08/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/30/2023