LISA MADHUKANTA SHAH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043992

License Status

EXPIRED

Business

Title

First Name

LISA

Middle

MADHUKANTA

Last Name

SHAH

Business Name

LISA MADHUKANTA SHAH MD

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006