CASEY ALLEN SHAFFER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049363

License Status

CANCELLED

Business

First Name

CASEY

Middle

ALLEN

Last Name

SHAFFER

Suffix

Business Name

CASEY ALLEN SHAFFER MD

Original Issue Date

06/25/2005

Effective Date

06/25/2005

Expiration Date

06/24/2008

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006