ATISH SHAH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

ACTIVE

Business

First Name

ATISH

Last Name

SHAH

Business Name

ATISH SHAH

Original Issue Date

08/28/2023

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

ROSELLE

State

Zip

60172

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/23/2024