SHIRLEY LYNNE VAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

Title

First Name

SHIRLEY

Middle

LYNNE

Last Name

VAN

Business Name

SHIRLEY LYNNE VAN MD

Original Issue Date

05/11/2023

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023