ANITA PRAVIN GANDHY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

ANITA

Middle

PRAVIN

Last Name

GANDHY

Business Name

ANITA PRAVIN GANDHY

Original Issue Date

07/23/2002

Effective Date

07/23/2002

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006