SHANE JOSEPH LARUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

Title

First Name

SHANE

Middle

JOSEPH

Last Name

LARUE

Business Name

SHANE JOSEPH LARUE MD

Original Issue Date

05/02/2020

Effective Date

05/02/2020

Expiration Date

07/31/2023

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023