The holder whose full name is Shackleford, Edward Lee Paul,come from Gurnee IL,hold the Osteopathic Physician license(NO.02001705A) which status is Expired Non-Renewable.
Name | Shackleford, Edward Lee Paul |
---|---|
License Number | 02001705A |
License Type | Osteopathic Physician |
License Status | Expired Non-Renewable |
City | Gurnee |
State | IL |