RAVI P GRIVOIS-SHAH MD 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

RAVI

Middle

Last Name

GRIVOIS-SHAH

Suffix

Business Name

RAVI P GRIVOIS-SHAH MD

Original Issue Date

08/14/2007

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014