ANKITA PRATIK SHAH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

NOT RENEWED

Business

First Name

ANKITA

Middle

PRATIK

Last Name

SHAH

Business Name

ANKITA PRATIK SHAH

Original Issue Date

02/03/2015

Effective Date

01/07/2020

Expiration Date

03/01/2022

City

NORTH AURORA

State

Zip

60542

County

KANE

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022