ARIE CE'VILLE SHAW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

Title

First Name

ARIE

Middle

CE'VILLE

Last Name

SHAW

Business Name

ARIE CE'VILLE SHAW MD

Original Issue Date

07/18/2016

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

PEKIN

State

Zip

61554

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021