SHINE JOHN DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****84

License Status

CANCELLED

Business

First Name

SHINE

Last Name

JOHN

Suffix

DPM

Business Name

SHINE JOHN DPM

Original Issue Date

05/07/2008

Effective Date

12/24/2008

Expiration Date

01/31/2011

City

DES PLAINES

State

Zip

60016

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/03/2010