AMI DEEPAK MODI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036152893

License Status

ACTIVE

Business

Title

First Name

AMI

Middle

DEEPAK

Last Name

MODI

Business Name

AMI DEEPAK MODI DO

Original Issue Date

05/07/2020

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2023