SHYAM GIRISH PATEL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059057

License Status

EXPIRED

Business

Title

First Name

SHYAM

Middle

GIRISH

Last Name

PATEL

Business Name

SHYAM GIRISH PATEL MD

Original Issue Date

05/01/2014

Effective Date

05/01/2014

Expiration Date

06/30/2015

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/04/2015