SHANNON B RIDER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039427

License Status

EXPIRED

Business

First Name

SHANNON

Middle

Last Name

RIDER

Business Name

SHANNON B RIDER

Original Issue Date

06/26/1999

Effective Date

06/26/1999

Expiration Date

06/25/2002

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006