PALAV JITENDRA SHAH DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

Title

First Name

PALAV

Middle

JITENDRA

Last Name

SHAH

Business Name

PALAV JITENDRA SHAH DO

Original Issue Date

02/09/2015

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60609

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021