KUSHAL JITENDRA SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058807

License Status

CANCELLED

Business

Title

First Name

KUSHAL

Middle

JITENDRA

Last Name

SHAH

Business Name

KUSHAL JITENDRA 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

Internal Medicine

Ever Disciplined

LastModifiedDate

06/18/2010