MITUL V PATEL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

ACTIVE

Business

First Name

MITUL

Middle

Last Name

PATEL

Suffix

DMD

Business Name

MITUL V PATEL DMD

Original Issue Date

07/05/2011

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024