BRIAN PATRICK SHORTAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

First Name

BRIAN

Middle

PATRICK

Last Name

SHORTAL

Suffix

Business Name

BRIAN PATRICK SHORTAL MD

Original Issue Date

06/09/2004

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

BANNOCKBURN

State

Zip

60015

County

LAKE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

04/07/2023