MARK TAKAYOSHI SHIMA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

TAKAYOSHI

Last Name

SHIMA

Business Name

MARK TAKAYOSHI SHIMA DO

Original Issue Date

03/02/2017

Effective Date

07/09/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61820

County

KENTUCKY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/09/2023