DIPESH SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

Title

First Name

DIPESH

Last Name

SHAH

Business Name

DIPESH SHAH MD

Original Issue Date

07/16/2020

Effective Date

07/16/2020

Expiration Date

07/31/2023

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023