PRATISH AJAY SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137694

License Status

ACTIVE

Business

Title

First Name

PRATISH

Middle

AJAY

Last Name

SHAH

Business Name

PRATISH AJAY SHAH MD

Original Issue Date

03/31/2015

Effective Date

07/28/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/28/2023