SHELLY L JOHNSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

SHELLY

Middle

Last Name

JOHNSEN

Suffix

Business Name

SHELLY L JOHNSEN MD

Original Issue Date

04/27/2020

Effective Date

04/27/2020

Expiration Date

07/31/2023

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023