KEVIN L SHADY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

KEVIN L

Last Name

SHADY

Suffix

Business Name

KEVIN L SHADY MD

Original Issue Date

03/15/1994

Effective Date

06/01/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021