TIMOTHY A SHAW DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****36

NOT RENEWED

N

TIMOTHY

A

SHAW

DO

TIMOTHY A SHAW DO

07/28/1998

07/28/1998

07/31/1999

CHICAGO

IL

60611

COOK

II III IV V

N

09/26/2006