SUSAN P SHANE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017407

License Status

EXPIRED

Business

First Name

SUSAN

Middle

Last Name

SHANE

Business Name

SUSAN P SHANE

Original Issue Date

07/10/1984

Effective Date

07/10/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60618

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006