SHAWN ASHLEY KACKER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

SHAWN

Middle

ASHLEY

Last Name

KACKER

Business Name

SHAWN ASHLEY KACKER DO

Original Issue Date

09/24/2022

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

04/06/2023