SHANNA CLAIRE TEN CLAY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

Title

First Name

SHANNA

Middle

CLAIRE

Last Name

TEN CLAY

Business Name

SHANNA CLAIRE TEN CLAY MD

Original Issue Date

03/25/2023

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023