SHIRENE M NOURBASH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

SHIRENE

Middle

Last Name

NOURBASH

Business Name

SHIRENE M NOURBASH

Original Issue Date

09/16/1997

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021