PETER HAYWOOD SHAW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

PETER HAYWOOD

Last Name

SHAW

Suffix

Business Name

PETER HAYWOOD SHAW MD

Original Issue Date

06/01/2004

Effective Date

06/01/2004

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006