SHAY E FISH Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

First Name

SHAY E

Last Name

FISH

Business Name

SHAY E FISH

Original Issue Date

05/08/1997

Effective Date

05/08/1997

Expiration Date

01/31/2003

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006