SHAWN M FRY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

SHAWN

Middle

Last Name

FRY

Business Name

SHAWN M FRY

Original Issue Date

01/31/2003

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023