KIRK VAN SHEPARD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

KIRK

Middle

VAN

Last Name

SHEPARD

Business Name

KIRK VAN SHEPARD MD

Original Issue Date

12/13/2019

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023