SAMIT B SHAH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059459

License Status

CANCELLED

Business

Title

First Name

SAMIT

Middle

Last Name

SHAH

Business Name

SAMIT B SHAH DO

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014