LISA J SHIVES Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

SHIVES

Business Name

LISA J SHIVES

Original Issue Date

03/26/2003

Effective Date

06/05/2014

Expiration Date

07/31/2017

City

EVANSTON

State

Zip

60203

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020