KYLE P SHEPPERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

KYLE

Middle

Last Name

SHEPPERSON

Suffix

Business Name

KYLE P SHEPPERSON MD

Original Issue Date

05/02/2003

Effective Date

06/18/2008

Expiration Date

07/31/2011

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020