SHANNON B RIDER Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

RIDER

Business Name

SHANNON B RIDER

Original Issue Date

04/04/2002

Effective Date

07/10/2023

Expiration Date

07/31/2026

City

HARRISBURG

State

Zip

62946

County

SALINE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/10/2023