JOHN CARROLL SHIVELY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114386

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

CARROLL

Last Name

SHIVELY

Suffix

Business Name

JOHN CARROLL SHIVELY MD

Original Issue Date

08/10/2005

Effective Date

05/14/2014

Expiration Date

07/31/2017

City

LAFAYETTE

State

Zip

47905

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017