LORI KRISTIN HARLEY SHADOW MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036161386

License Status

ACTIVE

Business

Title

First Name

LORI KRISTIN

Middle

HARLEY

Last Name

SHADOW

Business Name

LORI KRISTIN HARLEY SHADOW MD

Original Issue Date

07/12/2022

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

KAYSVILLE

State

Zip

84037

Ever Disciplined

LastModifiedDate

04/28/2023