SUDHA P SHAH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069064

License Status

INACTIVE

Business

First Name

SUDHA P

Last Name

SHAH

Suffix

Business Name

SUDHA P SHAH MD

Original Issue Date

07/20/1984

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/05/2020