BHAVYA R SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

Title

First Name

BHAVYA

Middle

Last Name

SHAH

Business Name

BHAVYA R SHAH MD

Original Issue Date

07/08/2013

Effective Date

08/20/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017