SIDDHARTH P SHAH 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

First Name

SIDDHARTH

Middle

Last Name

SHAH

Business Name

SIDDHARTH P SHAH

Original Issue Date

05/10/2007

Effective Date

05/10/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008