SHIVANI MANOJ SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055901

License Status

CANCELLED

Business

Title

First Name

SHIVANI

Middle

MANOJ

Last Name

SHAH

Business Name

SHIVANI MANOJ SHAH MD

Original Issue Date

06/23/2009

Effective Date

06/23/2009

Expiration Date

06/22/2012

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/10/2009