LUCAS SHAWN HENRY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

LUCAS

Middle

SHAWN

Last Name

HENRY

Business Name

LUCAS SHAWN HENRY

Original Issue Date

03/11/2011

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014