SHANDA L RILEY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112069

License Status

NOT RENEWED

Business

First Name

SHANDA

Middle

Last Name

RILEY

Business Name

SHANDA L RILEY

Original Issue Date

08/10/2004

Effective Date

08/10/2004

Expiration Date

07/31/2005

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/21/2013