YOGENDRA A SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

YOGENDRA A

Last Name

SHAH

Suffix

Business Name

YOGENDRA A SHAH MD

Original Issue Date

09/08/2017

Effective Date

09/08/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021