SHAWN W FENOUGHTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

SHAWN W

Last Name

FENOUGHTY

Suffix

Business Name

SHAWN W FENOUGHTY MD

Original Issue Date

02/20/1996

Effective Date

02/20/1996

Expiration Date

07/31/2002

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006