SHAWN MARK JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126002

License Status

NOT RENEWED

Business

Title

First Name

SHAWN

Middle

MARK

Last Name

JOHNSON

Business Name

SHAWN MARK JOHNSON MD

Original Issue Date

06/09/2010

Effective Date

06/28/2011

Expiration Date

07/31/2014

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Ever Disciplined

LastModifiedDate

11/17/2014