MICHAEL SHANE ERICKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127987

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

SHANE

Last Name

ERICKSON

Business Name

MICHAEL SHANE ERICKSON MD

Original Issue Date

06/01/2011

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014