KIMBERLAND SHARESH ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

KIMBERLAND

Middle

SHARESH

Last Name

ANDERSON

Suffix

Business Name

KIMBERLAND SHARESH ANDERSON MD

Original Issue Date

06/12/2009

Effective Date

06/28/2011

Expiration Date

07/31/2014

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014