BRIAN SHAWN NELSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051994

License Status

CANCELLED

Business

First Name

BRIAN

Middle

SHAWN

Last Name

NELSON

Suffix

Business Name

BRIAN SHAWN NELSON MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006