MICHAEL BRYAN SHANE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

BRYAN

Last Name

SHANE

Business Name

MICHAEL BRYAN SHANE MD

Original Issue Date

05/14/2013

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

WILMETTE

State

Zip

60091

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023