SHANNON G GRITZENBACH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111910

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

GRITZENBACH

Business Name

SHANNON G GRITZENBACH

Original Issue Date

07/21/2004

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/13/2023