SAMIR HARISHKUMAR SHAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

First Name

SAMIR

Middle

HARISHKUMAR

Last Name

SHAH

Suffix

Business Name

SAMIR HARISHKUMAR SHAH MD

Original Issue Date

11/29/2001

Effective Date

06/26/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/26/2023