SHAIVALKUMAR SAILESHKUMAR PATEL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

ACTIVE

Business

First Name

SHAIVALKUMAR

Middle

SAILESHKUMAR

Last Name

PATEL

Business Name

SHAIVALKUMAR SAILESHKUMAR PATEL

Original Issue Date

07/14/2017

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

SCHAUMBURG

State

Zip

60193

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024