CHARLES RAYMOND SHEPARDSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

CANCELLED

Business

First Name

CHARLES RAYMOND

Last Name

SHEPARDSON

Suffix

Business Name

CHARLES RAYMOND SHEPARDSON MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2002

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006