MUKESH D BHAKTA DPM - Podiatrist License in Illinois | # 31*****66

MUKESH D BHAKTA DPM

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

N

First Name

MUKESH

Middle

D

Last Name

BHAKTA

Suffix

DPM

Business Name

MUKESH D BHAKTA DPM

Original Issue Date

07/17/2000

Effective Date

07/17/2000

Expiration Date

01/31/2005

State

IL

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

10/09/2006