GAUTAM KRISHNAKA SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057748

License Status

NOT RENEWED

Business

First Name

GAUTAM KRISHNAKA

Last Name

SHAH

Suffix

Business Name

GAUTAM KRISHNAKA SHAH MD

Original Issue Date

08/21/1978

Effective Date

08/21/1978

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006