SHANNON EILEEN STALEY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056477

License Status

EXPIRED

Business

Title

First Name

SHANNON

Middle

EILEEN

Last Name

STALEY

Business Name

SHANNON EILEEN STALEY MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

Pediatric Emergency Medicine

Ever Disciplined

LastModifiedDate

09/04/2015