CHARLES HERSHEL SHALLAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036040891

License Status

NOT RENEWED

Business

First Name

CHARLES HERSHEL

Last Name

SHALLAT

Suffix

Business Name

CHARLES HERSHEL SHALLAT MD

Original Issue Date

01/20/1967

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008