MARK J SHEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059391

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

Last Name

SHEN

Business Name

MARK J SHEN MD

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/19/2011