BENJAMIN ISAAC SHEPHERD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000293

License Status

EXPIRED

Business

First Name

BENJAMIN

Middle

ISAAC

Last Name

SHEPHERD

Suffix

Business Name

BENJAMIN ISAAC SHEPHERD MD

Original Issue Date

05/01/2007

Effective Date

05/01/2007

Expiration Date

10/31/2007

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

12/05/2007