VIPUL LALITKUMAR SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

VIPUL

Middle

LALITKUMAR

Last Name

SHAH

Suffix

Business Name

VIPUL LALITKUMAR SHAH MD

Original Issue Date

03/03/2006

Effective Date

03/03/2006

Expiration Date

07/31/2008

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008