LISA MADHUKANTA SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

LISA

Middle

MADHUKANTA

Last Name

SHAH

Business Name

LISA MADHUKANTA SHAH MD

Original Issue Date

08/15/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/10/2011