SHANE GARDNER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079631

License Status

CANCELLED

Business

Title

First Name

SHANE

Last Name

GARDNER

Business Name

SHANE GARDNER DO

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

03/17/2025