License holder summary

WALLIS SHAIN SULLIVAN is a Medicine (Physician, Including M Ds & D Os) licensed to practice in New York. The address on file for WALLIS SHAIN SULLIVAN is MANLIUS NY. This doctor license is current. The license was granted 04/18/2012 and expired on 08/31/2015.

New York

Office of the Professions

WALLIS SHAIN SULLIVAN
Medicine (Physician, Including M Ds & D Os)
License number
264957
Date granted
04/18/2012
Date expires
08/31/2015
Class
Medicine (Physician, Including M Ds & D Os)
Status
Registered
Address
MANLIUS NY
nymedicine.org
ID 30305474
LAST UPDATED 2024-02-12 17:55:44 UTC

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