RAKESH J SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

CANCELLED

Business

First Name

RAKESH

Middle

Last Name

SHAH

Suffix

Business Name

RAKESH J SHAH MD

Original Issue Date

04/16/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011