DAVID SHABAZ ALLY ESHAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

SHABAZ ALLY

Last Name

ESHAK

Business Name

DAVID SHABAZ ALLY ESHAK MD

Original Issue Date

06/27/2016

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63141

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023