PUSHPA 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

PUSHPA A

Last Name

SHAH

Suffix

Business Name

PUSHPA A SHAH MD

Original Issue Date

01/01/1997

Effective Date

08/26/2008

Expiration Date

07/31/2011

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017