JAY DHIREN SHAH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

JAY

Middle

DHIREN

Last Name

SHAH

Business Name

JAY DHIREN SHAH

Original Issue Date

09/23/2011

Effective Date

09/23/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017