BIJAL SHAH MODI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002998

License Status

NOT RENEWED

Business

First Name

BIJAL

Middle

SHAH

Last Name

MODI

Business Name

BIJAL SHAH MODI

Original Issue Date

07/12/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Ever Disciplined

LastModifiedDate

12/16/2010