SHANNON G GRITZENBACH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040628

License Status

EXPIRED

Business

First Name

SHANNON

Middle

Last Name

GRITZENBACH

Business Name

SHANNON G GRITZENBACH

Original Issue Date

06/20/2000

Effective Date

06/20/2000

Expiration Date

06/19/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006