MAHASUKH H SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

MAHASUKH

Middle

Last Name

SHAH

Suffix

Business Name

MAHASUKH H SHAH MD

Original Issue Date

03/29/2006

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

11/01/2017