SHANE DAVID BUSH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058884

License Status

CANCELLED

Business

Title

First Name

SHANE

Middle

DAVID

Last Name

BUSH

Business Name

SHANE DAVID BUSH MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/14/2010