SHAWN S WALLERY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

Title

First Name

SHAWN S

Last Name

WALLERY

Business Name

SHAWN S WALLERY MD

Original Issue Date

04/28/2010

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

BYRON

State

Zip

61010

County

OGLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2023