PAYAL PARESH SHAH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

NOT RENEWED

Business

First Name

PAYAL

Middle

PARESH

Last Name

SHAH

Business Name

PAYAL PARESH SHAH

Original Issue Date

10/13/2017

Effective Date

02/02/2022

Expiration Date

03/01/2024

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025