FAWAD J SHAH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

Title

DMD

First Name

FAWAD

Middle

Last Name

SHAH

Business Name

FAWAD J SHAH DMD

Original Issue Date

08/07/2008

Effective Date

09/30/2015

Expiration Date

09/30/2018

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018