DAMPA NIKHIL SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050171

License Status

CANCELLED

Business

First Name

DAMPA

Middle

NIKHIL

Last Name

SHAH

Suffix

Business Name

DAMPA NIKHIL SHAH MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006