JENNIFER LEE SHASTRY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069308

License Status

CANCELLED

Business

Title

First Name

JENNIFER

Middle

LEE

Last Name

SHASTRY

Business Name

JENNIFER LEE SHASTRY MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

03/13/2019