AMIT SANTOSH DATE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126212

License Status

NOT RENEWED

Business

First Name

AMIT

Middle

SANTOSH

Last Name

DATE

Suffix

Business Name

AMIT SANTOSH DATE MD

Original Issue Date

07/07/2010

Effective Date

07/01/2020

Expiration Date

07/31/2023

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/30/2023