SHAKUNTALA SACHIN PATIL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062971

License Status

EXPIRED

Business

Title

First Name

SHAKUNTALA

Middle

SACHIN

Last Name

PATIL

Business Name

SHAKUNTALA SACHIN PATIL MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/30/2018