TEJASKUMAR M SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055760

License Status

CANCELLED

Business

Title

First Name

TEJASKUMAR

Middle

Last Name

SHAH

Business Name

TEJASKUMAR M SHAH MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/28/2009