MODASER SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

MODASER

Last Name

SHAH

Suffix

Business Name

MODASER SHAH MD

Original Issue Date

06/18/1987

Effective Date

06/18/1987

Expiration Date

07/31/1993

City

ALTON

State

Zip

62002

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020