SHRUNJAL MANISH SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

Title

First Name

SHRUNJAL

Middle

MANISH

Last Name

SHAH

Business Name

SHRUNJAL MANISH SHAH MD

Original Issue Date

07/13/2022

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023