SHAWN B KHADEMI DPM Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****23

License Status

INACTIVE

Business

Title

DPM

First Name

SHAWN

Middle

Last Name

KHADEMI

Business Name

SHAWN B KHADEMI DPM

Original Issue Date

07/24/2019

Effective Date

11/08/2020

Expiration Date

01/31/2023

City

CRYSTAL LAKE

State

Zip

60014

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/19/2020