SHELBY J BENNETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

Title

First Name

SHELBY

Middle

Last Name

BENNETT

Business Name

SHELBY J BENNETT MD

Original Issue Date

05/09/2013

Effective Date

05/09/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017