KEIVAN SHALILEH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150264

License Status

NOT RENEWED

Business

Title

First Name

KEIVAN

Last Name

SHALILEH

Business Name

KEIVAN SHALILEH MD

Original Issue Date

07/19/2019

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/30/2023