SHIVANI GIRISH THAKKAR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061824

License Status

CANCELLED

Business

Title

First Name

SHIVANI

Middle

GIRISH

Last Name

THAKKAR

Business Name

SHIVANI GIRISH THAKKAR MD

Original Issue Date

06/25/2013

Effective Date

06/25/2013

Expiration Date

06/24/2015

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

03/24/2014