IVAN LEE SHAPIRO MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043563

License Status

INACTIVE

Business

First Name

IVAN LEE

Last Name

SHAPIRO

Suffix

Business Name

IVAN LEE SHAPIRO MD

Original Issue Date

07/13/1970

Effective Date

07/13/1970

Expiration Date

07/31/1999

City

FORT FAIRFIELD

State

Zip

04742

County

MAINE

Ever Disciplined

LastModifiedDate

09/20/2006