PRAVIN S SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

PRAVIN

Middle

Last Name

SHAH

Suffix

Business Name

PRAVIN S SHAH MD

Original Issue Date

01/01/1997

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

1988000131

Action

Probation

Discipline Start Date

05/11/1998

Discipline End Date

05/10/2000