GARY DEAN SHACKELFORD MD - Medical Doctor License in Missouri | # 036043983

GARY DEAN SHACKELFORD MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043983

License Status

NOT RENEWED

Business

N

First Name

GARY DEAN

Last Name

SHACKELFORD

Suffix

MD

Business Name

GARY DEAN SHACKELFORD MD

Original Issue Date

01/19/1971

Effective Date

01/19/1971

State

MO

Ever Disciplined

N

LastModifiedDate

09/20/2006