JANET MARIE SHACKELFORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

JANET

Middle

MARIE

Last Name

SHACKELFORD

Suffix

Business Name

JANET MARIE SHACKELFORD MD

Original Issue Date

06/05/1987

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020