DIWANTE JAMAL SHUFORD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079474

License Status

CANCELLED

Business

Title

First Name

DIWANTE

Middle

JAMAL

Last Name

SHUFORD

Business Name

DIWANTE JAMAL SHUFORD MD

Original Issue Date

06/20/2022

Effective Date

06/20/2022

Expiration Date

06/19/2025

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/17/2025