KAUSHIK HARSHAD SHAH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

KAUSHIK

Middle

HARSHAD

Last Name

SHAH

Business Name

KAUSHIK HARSHAD SHAH

Original Issue Date

12/27/2006

Effective Date

09/04/2012

Expiration Date

09/30/2015

City

BURBANK

State

Zip

60459

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016