DANIELLE A SHAFER DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****61

NOT RENEWED

N

DO

DANIELLE

A

SHAFER

DANIELLE A SHAFER DO

06/20/2002

04/25/2011

07/31/2014

MAYWOOD

IL

60153

COOK

II III IV V

N

11/17/2014