CHARLES T SHAW Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

First Name

CHARLES T

Last Name

SHAW

Business Name

CHARLES T SHAW

Original Issue Date

08/01/1989

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

RIVERSIDE

State

Zip

60546

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023