DIPEN V SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

DIPEN

Middle

Last Name

SHAH

Business Name

DIPEN V SHAH MD

Original Issue Date

05/06/2024

Effective Date

05/06/2024

Expiration Date

07/31/2026

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2024