SUJAL V PANCHAL MD 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

SUJAL

Middle

Last Name

PANCHAL

Suffix

Business Name

SUJAL V PANCHAL MD

Original Issue Date

07/20/2007

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

NEW LENOX

State

Zip

60451

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017