RUSSELL J SHAH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096397

License Status

NOT RENEWED

Business

First Name

RUSSELL J

Last Name

SHAH

Business Name

RUSSELL J SHAH

Original Issue Date

08/12/1997

Effective Date

08/12/1997

Expiration Date

07/31/2002

City

MARINA DEL REY

State

Zip

90292

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

10/09/2006