BASHARAT A SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

Title

First Name

BASHARAT

Middle

Last Name

SHAH

Business Name

BASHARAT A SHAH MD

Original Issue Date

10/02/2006

Effective Date

10/07/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60630

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014