NIKITA J SHAH Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****03

License Status

NOT RENEWED

Business

First Name

NIKITA

Middle

Last Name

SHAH

Business Name

NIKITA J SHAH

Original Issue Date

09/13/2017

Effective Date

01/30/2018

Expiration Date

09/30/2020

City

VERNON HILLS

State

Zip

60061

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021