CHARLES T SHAW Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020815

License Status

EXPIRED

Business

First Name

CHARLES T

Last Name

SHAW

Business Name

CHARLES T SHAW

Original Issue Date

05/13/1987

Effective Date

05/13/1987

Expiration Date

06/22/1990

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006