SHIRLEY LYNNE VAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036164415

License Status

ACTIVE

Business

Title

First Name

SHIRLEY

Middle

LYNNE

Last Name

VAN

Business Name

SHIRLEY LYNNE VAN MD

Original Issue Date

04/17/2023

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

04/05/2023