MANOJKUMAR C SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

MANOJKUMAR C

Last Name

SHAH

Suffix

Business Name

MANOJKUMAR C SHAH MD

Original Issue Date

12/05/1989

Effective Date

12/05/1989

Expiration Date

07/31/1993

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006