JAY VIPUL SHAH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057932

License Status

EXPIRED

Business

First Name

JAY

Middle

VIPUL

Last Name

SHAH

Suffix

Business Name

JAY VIPUL SHAH MD

Original Issue Date

06/21/2010

Effective Date

06/21/2010

Expiration Date

06/20/2013

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/07/2013