MATTHEW B SHANNON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

MATTHEW B

Last Name

SHANNON

Suffix

Business Name

MATTHEW B SHANNON MD

Original Issue Date

09/07/1995

Effective Date

09/07/1995

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

09/26/2006