PUSHPA A SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055693

License Status

NOT RENEWED

Business

First Name

PUSHPA A

Last Name

SHAH

Suffix

Business Name

PUSHPA A SHAH MD

Original Issue Date

09/23/1977

Effective Date

06/26/2014

Expiration Date

07/31/2017

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017