MICHAEL BRYAN SHANE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054305

License Status

EXPIRED

Business

Title

First Name

MICHAEL

Middle

BRYAN

Last Name

SHANE

Business Name

MICHAEL BRYAN SHANE MD

Original Issue Date

06/24/2008

Effective Date

06/24/2008

Expiration Date

06/23/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/19/2011