SHASHANK JAGDISH DAVE DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042892

License Status

EXPIRED

Business

First Name

SHASHANK

Middle

JAGDISH

Last Name

DAVE

Suffix

Business Name

SHASHANK JAGDISH DAVE DO

Original Issue Date

06/24/2001

Effective Date

06/24/2001

Expiration Date

06/23/2004

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006