NIRA SHASHIKANT PATEL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

First Name

NIRA

Middle

SHASHIKANT

Last Name

PATEL

Business Name

NIRA SHASHIKANT PATEL

Original Issue Date

04/05/2012

Effective Date

07/30/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016