TIMOTHY B SHORT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

TIMOTHY

Middle

Last Name

SHORT

Business Name

TIMOTHY B SHORT MD

Original Issue Date

09/17/2010

Effective Date

06/24/2011

Expiration Date

07/31/2014

City

GLENVIEW

State

Zip

60025

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014