SHANE SANJAY MEHTA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068835

License Status

CANCELLED

Business

Title

First Name

SHANE

Middle

SANJAY

Last Name

MEHTA

Business Name

SHANE SANJAY MEHTA DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

05/24/2019