License holder summary

Shana Rae Theobald is a Medical - Physician licensed to practice in Colorado. The address on file for Shana Rae Theobald is 152 15th Ave NW, Saint%20Paul, MN, 55112-5112. This licensed professional license is current. The license was granted 07/19/2012 and expired on 04/30/2015.

Colorado

Division of Professions and Occupations

Shana Rae Theobald
Medical - Physician
License number
51568
Date granted
07/19/2012
Date expires
04/30/2015
Class
Medical - Physician
Status
Active
Address
152 15th Ave NW, Saint%20Paul, MN, 55112-5112
coloradolicensing.org
ID 27428089
LAST UPDATED 2024-02-09 16:04:55 UTC

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