SHANNON WAGNER SIMMONS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052592

License Status

CANCELLED

Business

First Name

SHANNON

Middle

WAGNER

Last Name

SIMMONS

Suffix

Business Name

SHANNON WAGNER SIMMONS MD

Original Issue Date

06/18/2007

Effective Date

06/18/2007

Expiration Date

06/17/2010

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

04/11/2007