SHIVANI PATEL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

SHIVANI

Last Name

PATEL

Business Name

SHIVANI PATEL

Original Issue Date

03/19/2019

Effective Date

10/13/2021

Expiration Date

09/30/2024

City

MUNSTER

State

Zip

46321

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025