SHELLY STONE SHALLAT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101025

License Status

ACTIVE

Business

First Name

SHELLY

Middle

STONE

Last Name

SHALLAT

Suffix

Business Name

SHELLY STONE SHALLAT MD

Original Issue Date

08/16/1999

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

07/14/2023