TRUDY MIKHAIL SHADY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

First Name

TRUDY MIKHAIL

Last Name

SHADY

Suffix

Business Name

TRUDY MIKHAIL SHADY MD

Original Issue Date

08/16/1994

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023