RONALD FREDERICK SHALLAT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041233

License Status

INACTIVE

Business

First Name

RONALD FREDERICK

Last Name

SHALLAT

Suffix

Business Name

RONALD FREDERICK SHALLAT MD

Original Issue Date

07/28/1967

Effective Date

07/28/1967

Expiration Date

07/31/1987

City

BERKELEY

State

Zip

94705

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006