KARLA R SHIVELY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

KARLA R

Last Name

SHIVELY

Business Name

KARLA R SHIVELY

Original Issue Date

09/09/1996

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021