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Qaisar
Qaisar
Shah
Medical doctor
Brambleton, United States
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Florida Health Care Practitioner Data Portal
Full name
QAISAR SHAH
Job Title
Medical Doctor
Location
Brambleton, VA, USA
LIC ID
142122
Current License Expiration Date
31/01/2025
Original Date
01/04/2019
Professional Rank Code
ME
Effective Date
10/03/2023
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
Out of State
Practice Location Address Line 1
22967 Lois Lane
Practice Location Address City
BRAMBLETON
Practice Location Address State
VA
Practice Location Address Zipcode
20148
Mode Code
Dispensing Practitioner
Prescribing Indicator
N
Dispensing Indicator
Y
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