SHADY HENIEN

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****78

NOT RENEWED

N

SHADY

HENIEN

SHADY HENIEN

01/27/2020

09/08/2020

07/31/2023

SPRINGFIELD

IL

62701

SANGAMON

PRACTITIONER

II III IV V

N

11/30/2023