NIRANJAN CHAMPAK 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

NIRANJAN CHAMPAK

Last Name

SHAH

Suffix

Business Name

NIRANJAN CHAMPAK SHAH MD

Original Issue Date

08/14/1990

Effective Date

08/14/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020