SHANTAY DANIELLE THOMAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

SHANTAY

Middle

DANIELLE

Last Name

THOMAS

Business Name

SHANTAY DANIELLE THOMAS MD

Original Issue Date

07/26/2018

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023