PAYAL A SHAH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

ACTIVE

Business

First Name

PAYAL

Middle

Last Name

SHAH

Suffix

DDS

Business Name

PAYAL A SHAH DDS

Original Issue Date

11/05/2003

Effective Date

08/03/2024

Expiration Date

09/30/2027

City

BROOKFIELD

State

Zip

60513

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/03/2024