JEREMY SHAUN TALLEY DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117295

License Status

NOT RENEWED

Business

First Name

JEREMY

Middle

SHAUN

Last Name

TALLEY

Suffix

Business Name

JEREMY SHAUN TALLEY DO

Original Issue Date

12/13/2006

Effective Date

12/13/2006

Expiration Date

07/31/2008

City

HERMANN

State

Zip

65041

Ever Disciplined

LastModifiedDate

11/06/2008