SHIVALI SHAH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071777

License Status

CANCELLED

Business

Title

First Name

SHIVALI

Last Name

SHAH

Business Name

SHIVALI SHAH DO

Original Issue Date

06/25/2018

Effective Date

06/25/2018

Expiration Date

06/24/2021

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/01/2018