NATASHA RAE SHALLOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136129

License Status

NOT RENEWED

Business

Title

First Name

NATASHA

Middle

RAE

Last Name

SHALLOW

Business Name

NATASHA RAE SHALLOW MD

Original Issue Date

08/01/2014

Effective Date

08/01/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

2017005318

Action

Suspension

Discipline Start Date

08/21/2017

Discipline Reason

after Respondent's physician and surgeon licenses in both Montana and Washington were suspended.