PHALGUNI JITENDRA PATEL DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

ACTIVE

Business

First Name

PHALGUNI

Middle

JITENDRA

Last Name

PATEL

Suffix

DDS

Business Name

PHALGUNI JITENDRA PATEL DDS

Original Issue Date

09/13/2004

Effective Date

05/07/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2024