PRAMOD A SHAH MD 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

First Name

PRAMOD A

Last Name

SHAH

Suffix

Business Name

PRAMOD A SHAH MD

Original Issue Date

10/29/1982

Effective Date

10/29/1982

Expiration Date

07/31/1984

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006