SHANNON G GRITZENBACH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

First Name

SHANNON

Middle

Last Name

GRITZENBACH

Business Name

SHANNON G GRITZENBACH

Original Issue Date

01/26/2005

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/14/2023