SHANNON CHRISTINE BROUGHER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

SHANNON

Middle

CHRISTINE

Last Name

BROUGHER

Business Name

SHANNON CHRISTINE BROUGHER MD

Original Issue Date

07/07/2022

Effective Date

07/07/2022

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61605

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023