SERGEY SHUSHUNOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

SERGEY

Last Name

SHUSHUNOV

Suffix

Business Name

SERGEY SHUSHUNOV MD

Original Issue Date

11/09/1994

Effective Date

12/03/2018

Expiration Date

09/30/2020

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2013001574

Action

Revocation

Discipline Start Date

06/22/2015

Discipline End Date

09/02/2018

Discipline Reason

due to a conviction of a forcible felony.