TRUSHIL GAURAV SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057460

License Status

CANCELLED

Business

Title

First Name

TRUSHIL

Middle

GAURAV

Last Name

SHAH

Business Name

TRUSHIL GAURAV SHAH MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/28/2010