SHANIQUA CHANTEL JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068492

License Status

CANCELLED

Business

Title

First Name

SHANIQUA

Middle

CHANTEL

Last Name

JOHNSON

Business Name

SHANIQUA CHANTEL JOHNSON 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

04/18/2016