SHANNON CHRISTINE BROUGHER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072852

License Status

CANCELLED

Business

Title

First Name

SHANNON

Middle

CHRISTINE

Last Name

BROUGHER

Business Name

SHANNON CHRISTINE BROUGHER MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/20/2022

City

PEORIA

State

Zip

61605

County

ADAMS

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

04/23/2021