SHIVANI MANAHAR PATEL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

SHIVANI

Middle

MANAHAR

Last Name

PATEL

Business Name

SHIVANI MANAHAR PATEL

Original Issue Date

07/02/2020

Effective Date

07/02/2020

Expiration Date

01/31/2022

City

SCHAUMBURG

State

Zip

60173

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022