NIKITA C SHAH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

NIKITA C

Last Name

SHAH

Business Name

NIKITA C SHAH

Original Issue Date

08/24/1995

Effective Date

08/24/1995

Expiration Date

07/31/2002

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006