ANISH NITISH SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065115

License Status

CANCELLED

Business

Title

First Name

ANISH

Middle

NITISH

Last Name

SHAH

Business Name

ANISH NITISH SHAH MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/09/2014