BIREN S SHAH Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005692

License Status

ACTIVE

Business

First Name

BIREN

Middle

Last Name

SHAH

Business Name

BIREN S SHAH

Original Issue Date

01/25/2016

Effective Date

11/05/2024

Expiration Date

01/31/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/05/2024