SHRUTI MANISH DAVE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122001

License Status

ACTIVE

Business

Title

First Name

SHRUTI

Middle

MANISH

Last Name

DAVE

Business Name

SHRUTI MANISH DAVE MD

Original Issue Date

09/26/2008

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/11/2023