NIRANJAN CHAMPAK SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

NIRANJAN CHAMPAK

Last Name

SHAH

Suffix

Business Name

NIRANJAN CHAMPAK SHAH MD

Original Issue Date

07/23/1990

Effective Date

07/23/1990

Expiration Date

07/31/1993

City

DES PLAINES

State

Zip

60016

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020