JITENDRA J SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053972

License Status

NOT RENEWED

Business

First Name

JITENDRA J

Last Name

SHAH

Suffix

Business Name

JITENDRA J SHAH MD

Original Issue Date

12/09/1976

Effective Date

07/10/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

11/30/2023