MARK SHAHRAM SHAHIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

MARK

Middle

SHAHRAM

Last Name

SHAHIN

Business Name

MARK SHAHRAM SHAHIN

Original Issue Date

03/18/1996

Effective Date

03/18/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006