SONAL DEVENDRA SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065969

License Status

CANCELLED

Business

Title

First Name

SONAL

Middle

DEVENDRA

Last Name

SHAH

Business Name

SONAL DEVENDRA SHAH MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/30/2014