SHANNON KATHLEEN HEXTRUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

SHANNON

Middle

KATHLEEN

Last Name

HEXTRUM

Business Name

SHANNON KATHLEEN HEXTRUM MD

Original Issue Date

04/25/2025

Effective Date

04/25/2025

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/25/2025