PUSHPALATA S SHAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

CANCELLED

Business

First Name

PUSHPALATA S

Last Name

SHAH

Suffix

Business Name

PUSHPALATA S SHAH MD

Original Issue Date

12/08/1988

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

EVERGREEN PARK

State

Zip

60642

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014