SHANE SANJAY MEHTA DO

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****30

ACTIVE

N

DO

SHANE

SANJAY

MEHTA

SHANE SANJAY MEHTA DO

07/29/2019

06/15/2023

07/31/2026

OAK LAWN

IL

60453

COOK

PRACTITIONER

II III IV V

N

06/15/2023