ALEXANDER CHARLES SHAW DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071917

License Status

CANCELLED

Business

Title

First Name

ALEXANDER

Middle

CHARLES

Last Name

SHAW

Business Name

ALEXANDER CHARLES SHAW DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

LA GRANGE

State

Zip

60525

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/10/2018