BANSARI SHAH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

ACTIVE

Business

First Name

BANSARI

Last Name

SHAH

Business Name

BANSARI SHAH

Original Issue Date

08/19/2022

Effective Date

09/16/2024

Expiration Date

09/30/2027

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2024