SHAKEILLA LAVERN SHABAZZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036156674

License Status

NOT RENEWED

Business

First Name

SHAKEILLA

Middle

LAVERN

Last Name

SHABAZZ

Business Name

SHAKEILLA LAVERN SHABAZZ

Original Issue Date

04/23/2021

Effective Date

04/23/2021

Expiration Date

07/31/2023

City

AUSTIN

State

Zip

78704

Ever Disciplined

LastModifiedDate

11/30/2023