SHIVAM S PATEL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

First Name

SHIVAM

Middle

Last Name

PATEL

Business Name

SHIVAM S PATEL

Original Issue Date

06/20/2012

Effective Date

07/07/2024

Expiration Date

09/30/2027

City

BENSENVILLE

State

Zip

60106

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2024