HETAL R DAVE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109915

License Status

NOT RENEWED

Business

First Name

HETAL

Middle

Last Name

DAVE

Suffix

Business Name

HETAL R DAVE MD

Original Issue Date

08/13/2003

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017