GEORGE KENNETH SHOTICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

GEORGE KENNETH

Last Name

SHOTICK

Suffix

Business Name

GEORGE KENNETH SHOTICK MD

Original Issue Date

08/05/1996

Effective Date

08/05/1996

Expiration Date

07/31/2002

City

MONCKS CORNER

State

Zip

29461

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020