GAURAV R SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

CANCELLED

Business

First Name

GAURAV

Middle

Last Name

SHAH

Suffix

Business Name

GAURAV R SHAH MD

Original Issue Date

10/11/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011