NICHOLE MARIE SHAW MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

Title

First Name

NICHOLE

Middle

MARIE

Last Name

SHAW

Business Name

NICHOLE MARIE SHAW MD

Original Issue Date

02/26/2024

Effective Date

02/26/2024

Expiration Date

07/31/2026

City

ADDISON

State

Zip

60101

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/26/2024