SHAWN BANASH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073504

License Status

EXPIRED

Business

Title

First Name

SHAWN

Last Name

BANASH

Business Name

SHAWN BANASH MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/11/2022