Louisiana
Board of Licensing
Seals Michael Shane
Medical
License number
CLP.203801-GEN
Date expires
12/31/2014
Class
Medical
Status
Active
Address
4500 Thirteenth Street, Gulfport, MS 39501
louisianalicensing.com
ID 21814639
LAST UPDATED 2024-04-18 17:10:08 UTC
LAST UPDATED 2024-04-18 17:10:08 UTC