SHANNON RAE CONNOLLY DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

SHANNON

Middle

RAE

Last Name

CONNOLLY

Business Name

SHANNON RAE CONNOLLY DO

Original Issue Date

05/04/2015

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023