ELISHEVA DOUGLAS SHANES MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064646

License Status

CANCELLED

Business

Title

First Name

ELISHEVA

Middle

DOUGLAS

Last Name

SHANES

Business Name

ELISHEVA DOUGLAS SHANES MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

02/02/2017