SHANE PATRICK BURKE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071245

License Status

CANCELLED

Business

Title

First Name

SHANE

Middle

PATRICK

Last Name

BURKE

Business Name

SHANE PATRICK BURKE MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/18/2017