EMILY HEEEUN SHIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

Title

First Name

EMILY

Middle

HEEEUN

Last Name

SHIN

Business Name

EMILY HEEEUN SHIN MD

Original Issue Date

04/20/2019

Effective Date

04/20/2019

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021