SUHRUD JITENDRA SHAH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

ACTIVE

Business

Title

DMD

First Name

SUHRUD

Middle

JITENDRA

Last Name

SHAH

Business Name

SUHRUD JITENDRA SHAH DMD

Original Issue Date

07/15/2023

Effective Date

09/15/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60630

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/15/2024