DIPESHKUMAR H SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

Title

First Name

DIPESHKUMAR

Middle

Last Name

SHAH

Business Name

DIPESHKUMAR H SHAH MD

Original Issue Date

09/22/2008

Effective Date

09/22/2008

Expiration Date

07/31/2011

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020