JOHN STONE SHALLAT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100450

License Status

ACTIVE

Business

First Name

JOHN

Middle

STONE

Last Name

SHALLAT

Suffix

Business Name

JOHN STONE SHALLAT MD

Original Issue Date

06/28/1999

Effective Date

06/26/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

06/26/2023