SHAWN REUBEN TILLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

SHAWN REUBEN

Last Name

TILLER

Suffix

Business Name

SHAWN REUBEN TILLER MD

Original Issue Date

06/29/1997

Effective Date

06/29/1997

Expiration Date

07/31/2002

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006