BENJAMIN ISAAC SHEPHERD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

ISAAC

Last Name

SHEPHERD

Suffix

Business Name

BENJAMIN ISAAC SHEPHERD MD

Original Issue Date

05/15/2013

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

PRINCETON

State

Zip

61356

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021