SONAL DEVENDRA SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

Title

First Name

SONAL

Middle

DEVENDRA

Last Name

SHAH

Business Name

SONAL DEVENDRA SHAH MD

Original Issue Date

07/28/2016

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023