ANDREW JOHN SHADRACH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078917

License Status

CANCELLED

Business

Title

First Name

ANDREW

Middle

JOHN

Last Name

SHADRACH

Business Name

ANDREW JOHN SHADRACH MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

PEORIA

State

Zip

61605

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/26/2021