SHANNON C PETTIT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076963

License Status

CANCELLED

Business

Title

First Name

SHANNON

Middle

Last Name

PETTIT

Business Name

SHANNON C PETTIT MD

Original Issue Date

06/24/2020

Effective Date

06/24/2020

Expiration Date

06/23/2023

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

04/23/2020