PRATIK B PATEL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000228

License Status

EXPIRED

Business

First Name

PRATIK

Middle

Last Name

PATEL

Suffix

Business Name

PRATIK B PATEL MD

Original Issue Date

12/01/2004

Effective Date

12/01/2004

Expiration Date

06/06/2005

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/23/2006