PREM BHARAT PATEL MD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

INACTIVE

Business

Title

First Name

PREM

Middle

BHARAT

Last Name

PATEL

Business Name

PREM BHARAT PATEL MD

Original Issue Date

07/28/2016

Effective Date

08/16/2018

Expiration Date

12/31/2021

City

CHICAGO

State

Zip

60638

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/28/2021