BHUMIK K SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

BHUMIK

Middle

Last Name

SHAH

Suffix

Business Name

BHUMIK K SHAH MD

Original Issue Date

12/19/2018

Effective Date

08/22/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/22/2023