SCOTT ALLEN SHAPPARD DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039777

License Status

EXPIRED

Business

First Name

SCOTT

Middle

ALLEN

Last Name

SHAPPARD

Suffix

Business Name

SCOTT ALLEN SHAPPARD DO

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006