ANKITA K SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

CANCELLED

Business

First Name

ANKITA

Middle

Last Name

SHAH

Suffix

Business Name

ANKITA K SHAH MD

Original Issue Date

05/06/2009

Effective Date

05/06/2009

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

04/07/2011