ANISH NITISH SHAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

Title

First Name

ANISH

Middle

NITISH

Last Name

SHAH

Business Name

ANISH NITISH SHAH MD

Original Issue Date

08/02/2016

Effective Date

08/02/2016

Expiration Date

07/31/2017

City

LA GRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017