License Type:
Dentist
License Number:
2901019565
Name:
Thomas Patrick Shannon
License Issue Date:
05/03/2007
License Expiration Date:
05/03/2027
License Status:
Revoked
County:
Kent
Specialty Certification:
Orthodontics
Status:
Lapsed
Issue Date:
02/12/2014
Expiration Date:
City:
Grandville
State or Province:
Michigan
ZIP or Postal Code:
49418
CS Record Number:
5315030987
CS Status:
Lapsed - Suspended
CS Expiration Date:
05/03/2024