NISHITH SURESH SHAH DMD - Dentist License in Arizona | # 31*****26

NISHITH SURESH SHAH DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

N

First Name

NISHITH SURESH

Last Name

SHAH

Suffix

DMD

Business Name

NISHITH SURESH SHAH DMD

Original Issue Date

11/05/1997

Effective Date

08/24/2012

Expiration Date

09/30/2015

State

AZ

Controlled Substance Schedule

II

Ever Disciplined

N

LastModifiedDate

02/08/2016