MICHAEL SHANNON WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

SHANNON

Last Name

WILSON

Suffix

Business Name

MICHAEL SHANNON WILSON MD

Original Issue Date

03/26/1985

Effective Date

03/26/1985

Expiration Date

07/31/1987

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006