SHANNON WAGNER SIMMONS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

WAGNER

Last Name

SIMMONS

Suffix

Business Name

SHANNON WAGNER SIMMONS MD

Original Issue Date

08/20/2009

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014