SHIVAM CHANDRAGUPTA VEDAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076244

License Status

CANCELLED

Business

Title

First Name

SHIVAM

Middle

CHANDRAGUPTA

Last Name

VEDAK

Business Name

SHIVAM CHANDRAGUPTA VEDAK MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/01/2021