SHITAL R SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106641

License Status

NOT RENEWED

Business

First Name

SHITAL

Middle

Last Name

SHAH

Suffix

Business Name

SHITAL R SHAH MD

Original Issue Date

03/29/2002

Effective Date

03/29/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006