ISHANA PREMA SHETTY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

ISHANA

Middle

PREMA

Last Name

SHETTY

Business Name

ISHANA PREMA SHETTY MD

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

07/31/2026

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/05/2025