SHAPING SUN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

First Name

SHAPING

Last Name

SUN

Suffix

Business Name

SHAPING SUN MD

Original Issue Date

12/23/2004

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

ST LOUIS

State

Zip

63106

County

MISSOURI

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/10/2023