Louisiana
Board of Licensing
Broussard Shane Thomas
Medical
License number
PA.A10272.RX
Date expires
03/31/2015
Class
Medical
Status
Active
Address
1448 S. College Dr., Lafayette, LA 70503
louisianalicensing.com
ID 22002139
LAST UPDATED 2024-03-16 10:30:20 UTC
LAST UPDATED 2024-03-16 10:30:20 UTC