SHIRA SIVAN SIMON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

SHIRA

Middle

SIVAN

Last Name

SIMON

Suffix

Business Name

SHIRA SIVAN SIMON MD

Original Issue Date

11/28/2017

Effective Date

11/28/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021