KENNETH MARK SHANOFF Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012526

License Status

EXPIRED

Business

First Name

KENNETH MARK

Last Name

SHANOFF

Business Name

KENNETH MARK SHANOFF

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

05/27/1983

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006