SAMIR SURESH SHAH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046255

License Status

EXPIRED

Business

First Name

SAMIR

Middle

SURESH

Last Name

SHAH

Suffix

Business Name

SAMIR SURESH SHAH MD

Original Issue Date

06/17/2003

Effective Date

06/17/2003

Expiration Date

06/16/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006