SUSAN JANE SHEPPARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

JANE

Last Name

SHEPPARD

Suffix

Business Name

SUSAN JANE SHEPPARD MD

Original Issue Date

12/16/1999

Effective Date

09/04/2020

Expiration Date

07/31/2023

City

BLOOMINGTON

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023