GHANSHYAM M SHAH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

GHANSHYAM M

Last Name

SHAH

Business Name

GHANSHYAM M SHAH

Original Issue Date

09/04/1997

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

ROLLING MEADOWS

State

Zip

60008

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023