SHANNON KATHLEEN MARTIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054966

License Status

CANCELLED

Business

Title

First Name

SHANNON

Middle

KATHLEEN

Last Name

MARTIN

Business Name

SHANNON KATHLEEN MARTIN 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

Internal Medicine

Ever Disciplined

LastModifiedDate

06/10/2008