INDRAVADAN P SHAH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068865

License Status

INACTIVE

Business

First Name

INDRAVADAN P

Last Name

SHAH

Suffix

Business Name

INDRAVADAN P SHAH MD

Original Issue Date

06/20/1984

Effective Date

06/20/1984

Expiration Date

07/31/1987

City

DAYTONA BEACH

State

Zip

32017

County

FLORIDA

Ever Disciplined

LastModifiedDate

01/20/2015

Case Number

2014007567

Action

Refuse To Renew

Discipline Start Date

10/07/2014

Discipline Reason

due to a sister-state discipline by the state of Florida.