RAKESH J SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

First Name

RAKESH

Middle

Last Name

SHAH

Suffix

Business Name

RAKESH J SHAH MD

Original Issue Date

02/01/2021

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023