ASHA SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

Title

First Name

ASHA

Last Name

SHAH

Business Name

ASHA SHAH MD

Original Issue Date

09/13/2016

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021