LISA J SHIVES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041897

License Status

EXPIRED

Business

First Name

LISA

Middle

Last Name

SHIVES

Business Name

LISA J SHIVES

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2002

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006