JACK E SHALLEY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077925

License Status

INACTIVE

Business

First Name

JACK E

Last Name

SHALLEY

Suffix

Business Name

JACK E SHALLEY MD

Original Issue Date

09/24/1988

Effective Date

09/24/1988

Expiration Date

07/31/1996

City

KANSAS CITY

State

Zip

64106

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006