SIDDHARTH PATEL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

First Name

SIDDHARTH

Last Name

PATEL

Business Name

SIDDHARTH PATEL

Original Issue Date

07/08/2022

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

BROOKHAVEN

State

Zip

30319

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023