RICHARD D SHAFFER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062136

License Status

CANCELLED

Business

Title

First Name

RICHARD

Middle

Last Name

SHAFFER

Business Name

RICHARD D SHAFFER MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014