SHANE S PAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

Last Name

PAK

Suffix

Business Name

SHANE S PAK MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006