MINTI VIJAY SHAH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074968

License Status

CANCELLED

Business

Title

First Name

MINTI

Middle

VIJAY

Last Name

SHAH

Business Name

MINTI VIJAY SHAH DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/16/2019