BRIAN S SHAH DDS, MD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

SHAH

Suffix

DDS, MD

Business Name

BRIAN S SHAH DDS, MD

Original Issue Date

03/09/2010

Effective Date

08/14/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018