JAY N SHAH Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

First Name

JAY

Middle

Last Name

SHAH

Business Name

JAY N SHAH

Original Issue Date

08/13/2003

Effective Date

08/13/2003

Expiration Date

07/31/2005

City

SCHAUMBURG

State

Zip

60173

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006