SUSAN SHAPIRO BRAITHWAITE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

INACTIVE

Business

First Name

SUSAN

Middle

SHAPIRO

Last Name

BRAITHWAITE

Suffix

Business Name

SUSAN SHAPIRO BRAITHWAITE MD

Original Issue Date

03/10/2008

Effective Date

05/23/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60659

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020