JACK E SHALLEY MD - Medical Doctor License in Missouri | # 036077925

JACK E SHALLEY MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077925

License Status

INACTIVE

Business

N

First Name

JACK E

Last Name

SHALLEY

Suffix

MD

Business Name

JACK E SHALLEY MD

Original Issue Date

09/24/1988

Effective Date

09/24/1988

Expiration Date

07/31/1996

State

MO

Ever Disciplined

N

LastModifiedDate

09/20/2006