SHASHI NARESH SHAH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

NOT RENEWED

Business

Title

DDS

First Name

SHASHI

Middle

NARESH

Last Name

SHAH

Business Name

SHASHI NARESH SHAH DDS

Original Issue Date

08/25/2016

Effective Date

06/15/2018

Expiration Date

01/31/2022

City

UTICA

State

Zip

61373

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022