LARRY ROLAND SHANNON MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****40

NOT RENEWED

N

LARRY

ROLAND

SHANNON

MD

LARRY ROLAND SHANNON MD

09/02/2009

09/02/2009

07/31/2011

CHICAGO

IL

60612

COOK

PRACTITIONER

II III IV V

N

11/10/2011