SHANA GITTLE KUSIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

Title

First Name

SHANA

Middle

GITTLE

Last Name

KUSIN

Business Name

SHANA GITTLE KUSIN MD

Original Issue Date

03/10/2011

Effective Date

03/10/2011

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011