INDRAVADAN P SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

INDRAVADAN P

Last Name

SHAH

Suffix

Business Name

INDRAVADAN P SHAH MD

Original Issue Date

11/01/1984

Effective Date

11/01/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60660

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006