VIPUL R MODI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125210

License Status

NOT RENEWED

Business

First Name

VIPUL

Middle

Last Name

MODI

Business Name

VIPUL R MODI

Original Issue Date

03/16/2010

Effective Date

03/16/2010

Expiration Date

07/31/2011

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011