KAUSHIK HARSHAD SHAH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

KAUSHIK

Middle

HARSHAD

Last Name

SHAH

Business Name

KAUSHIK HARSHAD SHAH

Original Issue Date

11/16/2006

Effective Date

07/16/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012