KETAN RAJENDRA MODY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

First Name

KETAN

Middle

RAJENDRA

Last Name

MODY

Business Name

KETAN RAJENDRA MODY

Original Issue Date

08/28/2007

Effective Date

07/01/2023

Expiration Date

07/31/2026

City

WESTMONT

State

Zip

60559

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/01/2023