LAWRENCE G SHAW MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036275

License Status

EXPIRED

Business

First Name

LAWRENCE

Middle

Last Name

SHAW

Suffix

Business Name

LAWRENCE G SHAW MD

Original Issue Date

05/21/1997

Effective Date

05/21/1997

Expiration Date

04/14/2001

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006