BHARAT J SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

BHARAT J

Last Name

SHAH

Suffix

Business Name

BHARAT J SHAH MD

Original Issue Date

06/29/2001

Effective Date

06/11/2014

Expiration Date

07/31/2017

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017