DIVYA SARATH SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065221

License Status

CANCELLED

Business

Title

First Name

DIVYA

Middle

SARATH

Last Name

SHAH

Business Name

DIVYA SARATH SHAH MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

06/11/2014