VICKIE SHAH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

NOT RENEWED

Business

First Name

VICKIE

Last Name

SHAH

Business Name

VICKIE SHAH

Original Issue Date

12/05/2017

Effective Date

01/21/2020

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

01/03/2022