THOMAS E SHINE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

SHINE

Business Name

THOMAS E SHINE

Original Issue Date

09/24/2001

Effective Date

09/24/2001

Expiration Date

07/31/2005

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006