SEERIN VIVIANE SHATAVI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053868

License Status

EXPIRED

Business

Title

First Name

SEERIN

Middle

VIVIANE

Last Name

SHATAVI

Business Name

SEERIN VIVIANE SHATAVI MD

Original Issue Date

09/25/2007

Effective Date

09/25/2007

Expiration Date

09/24/2010

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/13/2010