SUDHA P SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

SUDHA P

Last Name

SHAH

Suffix

Business Name

SUDHA P SHAH MD

Original Issue Date

01/01/1997

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020