NICOLE ROSE SHAW MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074351

License Status

EXPIRED

Business

Title

First Name

NICOLE

Middle

ROSE

Last Name

SHAW

Business Name

NICOLE ROSE SHAW MD

Original Issue Date

06/24/2022

Effective Date

06/24/2022

Expiration Date

06/23/2023

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

03/06/2024