SHANE MAXWELL DAVIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084655

License Status

ACTIVE

Business

Title

First Name

SHANE

Middle

MAXWELL

Last Name

DAVIS

Business Name

SHANE MAXWELL DAVIS MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

06/17/2024