SHIRISH D DEVASTHALI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072145

License Status

INACTIVE

Business

First Name

SHIRISH D

Last Name

DEVASTHALI

Suffix

Business Name

SHIRISH D DEVASTHALI MD

Original Issue Date

12/12/1985

Effective Date

12/12/1985

Expiration Date

07/31/1987

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/15/2012