DIPIKA JAYESH SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

DIPIKA

Middle

JAYESH

Last Name

SHAH

Suffix

Business Name

DIPIKA JAYESH SHAH MD

Original Issue Date

07/14/2000

Effective Date

07/14/2000

Expiration Date

07/31/2002

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006