NAIMI SHAH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

ACTIVE

Business

First Name

NAIMI

Last Name

SHAH

Business Name

NAIMI SHAH

Original Issue Date

08/27/2018

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61705

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024