JAY VIPUL SHAH MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049131423

License Status

NOT RENEWED

Business

First Name

JAY

Middle

VIPUL

Last Name

SHAH

Suffix

Business Name

JAY VIPUL SHAH MD

Original Issue Date

06/30/2000

Effective Date

01/19/2006

Expiration Date

03/31/2007

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

05/14/2007