LORNA D SHAW Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037207

License Status

CANCELLED

Business

First Name

LORNA

Middle

Last Name

SHAW

Business Name

LORNA D SHAW

Original Issue Date

08/15/1997

Effective Date

08/15/1997

Expiration Date

08/10/2000

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006