SHIREEN JUNE RUDDEROW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

SHIREEN

Middle

JUNE

Last Name

RUDDEROW

Suffix

Business Name

SHIREEN JUNE RUDDEROW MD

Original Issue Date

02/02/2005

Effective Date

02/02/2005

Expiration Date

07/31/2005

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006