AUTUMN SHASHAUNA DAVIDSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130015

License Status

NOT RENEWED

Business

Title

First Name

AUTUMN

Middle

SHASHAUNA

Last Name

DAVIDSON

Business Name

AUTUMN SHASHAUNA DAVIDSON MD

Original Issue Date

04/09/2012

Effective Date

06/11/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017