KEIVAN SHALILEH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069881

License Status

CANCELLED

Business

Title

First Name

KEIVAN

Last Name

SHALILEH

Business Name

KEIVAN SHALILEH MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pulmonary Disease

Ever Disciplined

LastModifiedDate

04/13/2017