RUSSELL J SHAH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033777

License Status

EXPIRED

Business

First Name

RUSSELL J

Last Name

SHAH

Business Name

RUSSELL J SHAH

Original Issue Date

07/11/1995

Effective Date

07/11/1995

Expiration Date

07/10/1998

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006