ANDREA H SHASHOUA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

SHASHOUA

Business Name

ANDREA H SHASHOUA

Original Issue Date

06/30/2011

Effective Date

04/18/2014

Expiration Date

07/31/2017

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020