License holder summary

NATHAN LEVI SHAW is a Board Of Medicine licensed to practice in Idaho. The address on file for NATHAN LEVI SHAW is 460 E Draper St Mesa AZ 85203. This licensed professional license is not current. The license was granted 05/29/2003 and expired on 06/30/2004.

Idaho

Division of Occupational and Professional Licenses

NATHAN LEVI SHAW
Board Of Medicine
License number
LRT-1007
Date granted
05/29/2003
Date expires
06/30/2004
Class
Board Of Medicine
Status
Canceled
Address
460 E Draper St Mesa AZ 85203
idaholicensing.com
ID 48339548
LAST UPDATED 2026-05-30 17:04:18 UTC

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