PRODYOT K MITRA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

PRODYOT K

Last Name

MITRA

Suffix

Business Name

PRODYOT K MITRA MD

Original Issue Date

01/01/1997

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

MCHENRY

State

Zip

60050

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023