COLBY SHAD THAXTON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050055

License Status

EXPIRED

Business

First Name

COLBY

Middle

SHAD

Last Name

THAXTON

Suffix

Business Name

COLBY SHAD THAXTON MD

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/22/2008

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

06/26/2008