SANJIV JAYENDRA SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

First Name

SANJIV

Middle

JAYENDRA

Last Name

SHAH

Suffix

Business Name

SANJIV JAYENDRA SHAH MD

Original Issue Date

06/29/2006

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023