SUMIT SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

Title

First Name

SUMIT

Last Name

SHAH

Business Name

SUMIT SHAH MD

Original Issue Date

10/14/2021

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023