RAJ L SHIVAJI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097085

License Status

NOT RENEWED

Business

Title

First Name

RAJ

Middle

Last Name

SHIVAJI

Business Name

RAJ L SHIVAJI MD

Original Issue Date

12/12/1997

Effective Date

02/02/2012

Expiration Date

07/31/2014

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/17/2014