DIPAK PRAVIN SHAH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045751

License Status

EXPIRED

Business

First Name

DIPAK

Middle

PRAVIN

Last Name

SHAH

Suffix

Business Name

DIPAK PRAVIN SHAH MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2006

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006