SHANNON R KELLEY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082709

License Status

INACTIVE

Business

First Name

SHANNON R

Last Name

KELLEY

Suffix

Business Name

SHANNON R KELLEY MD

Original Issue Date

06/26/1991

Effective Date

06/26/1991

Expiration Date

07/31/1993

City

LAFAYETTE

State

Zip

47904

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006