SHYAMAL M MADHAVANI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

SHYAMAL

Middle

Last Name

MADHAVANI

Business Name

SHYAMAL M MADHAVANI DO

Original Issue Date

06/19/2017

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023