LAURA K SHAW MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037248

License Status

EXPIRED

Business

First Name

LAURA

Middle

Last Name

SHAW

Suffix

Business Name

LAURA K SHAW MD

Original Issue Date

11/10/1997

Effective Date

11/10/1997

Expiration Date

01/06/2001

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006