SHANNON EILEEN STALEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

SHANNON

Middle

EILEEN

Last Name

STALEY

Business Name

SHANNON EILEEN STALEY MD

Original Issue Date

08/17/2012

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60467

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023