MARC DOUGLAS SHIELDS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106105

License Status

NOT RENEWED

Business

First Name

MARC

Middle

DOUGLAS

Last Name

SHIELDS

Suffix

Business Name

MARC DOUGLAS SHIELDS MD

Original Issue Date

01/15/2002

Effective Date

01/15/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006