DIPAK SHANTILAL SHAH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

First Name

DIPAK SHANTILAL

Last Name

SHAH

Suffix

DDS

Business Name

DIPAK SHANTILAL SHAH DDS

Original Issue Date

07/02/1993

Effective Date

08/25/2009

Expiration Date

09/30/2012

City

WESTMONT

State

Zip

60559

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012