JAY DHIREN SHAH Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052454

License Status

CANCELLED

Business

First Name

JAY

Middle

DHIREN

Last Name

SHAH

Business Name

JAY DHIREN SHAH

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/04/2007