LISA PRASHANT SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

LISA

Middle

PRASHANT

Last Name

SHAH

Business Name

LISA PRASHANT SHAH MD

Original Issue Date

08/06/2014

Effective Date

08/06/2014

Expiration Date

07/31/2017

City

OAK PARK

State

Zip

60301

County

COOK

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

11/01/2017