GAUTAM KANTILAL BHANUSHALI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

Title

First Name

GAUTAM

Middle

KANTILAL

Last Name

BHANUSHALI

Business Name

GAUTAM KANTILAL BHANUSHALI MD

Original Issue Date

04/01/2013

Effective Date

05/12/2023

Expiration Date

07/31/2026

City

JUSTICE

State

Zip

60458

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/12/2023