JESSALYN GALE SHAW MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068279

License Status

CANCELLED

Business

Title

First Name

JESSALYN

Middle

GALE

Last Name

SHAW

Business Name

JESSALYN GALE SHAW MD

Original Issue Date

06/23/2016

Effective Date

06/23/2016

Expiration Date

06/22/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/10/2016