GRACE BERRY LASHORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

Title

First Name

GRACE

Middle

BERRY

Last Name

LASHORE

Business Name

GRACE BERRY LASHORE MD

Original Issue Date

04/14/2015

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023