KHANTIL R SHAH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

Title

DMD

First Name

KHANTIL

Middle

Last Name

SHAH

Business Name

KHANTIL R SHAH DMD

Original Issue Date

12/20/2016

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60611

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022