KETAN A SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

KETAN

Middle

Last Name

SHAH

Suffix

Business Name

KETAN A SHAH MD

Original Issue Date

02/01/2000

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

County

MONROE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023