SHELLY BANSAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

SHELLY

Last Name

BANSAL

Business Name

SHELLY BANSAL MD

Original Issue Date

05/11/2022

Effective Date

05/11/2022

Expiration Date

07/31/2023

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023