KATHLEEN M SHAW Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

KATHLEEN M

Last Name

SHAW

Business Name

KATHLEEN M SHAW

Original Issue Date

01/01/1997

Effective Date

05/23/2011

Expiration Date

07/31/2014

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017