SHELLY BANSAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155469

License Status

NOT RENEWED

Business

Title

First Name

SHELLY

Last Name

BANSAL

Business Name

SHELLY BANSAL MD

Original Issue Date

02/01/2021

Effective Date

02/01/2021

Expiration Date

07/31/2023

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/30/2023