SHANIQUA CHANTEL JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149968

License Status

NOT RENEWED

Business

Title

First Name

SHANIQUA

Middle

CHANTEL

Last Name

JOHNSON

Business Name

SHANIQUA CHANTEL JOHNSON MD

Original Issue Date

06/26/2019

Effective Date

06/26/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021