PRATIMA M SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

PRATIMA M

Last Name

SHAH

Suffix

Business Name

PRATIMA M SHAH MD

Original Issue Date

10/14/1987

Effective Date

06/27/2014

Expiration Date

07/31/2017

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

1987002149

Action

Probation

Discipline Start Date

12/17/1987

Discipline End Date

12/16/1988