SHANA GITTLE KUSIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052646

License Status

EXPIRED

Business

Title

First Name

SHANA

Middle

GITTLE

Last Name

KUSIN

Business Name

SHANA GITTLE KUSIN 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

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/24/2010