JAY BHAGAVATI SHAH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076251

License Status

CANCELLED

Business

Title

First Name

JAY

Middle

BHAGAVATI

Last Name

SHAH

Prefix

Business Name

JAY BHAGAVATI SHAH DO

Original Issue Date

06/29/2020

Effective Date

06/29/2020

Expiration Date

06/28/2023

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/23/2020