MANISH N SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

CANCELLED

Business

First Name

MANISH

Middle

Last Name

SHAH

Suffix

Business Name

MANISH N SHAH MD

Original Issue Date

03/22/1999

Effective Date

03/22/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006