PANKAJ MANTAB JAIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

Title

First Name

PANKAJ

Middle

MANTAB

Last Name

JAIN

Business Name

PANKAJ MANTAB JAIN MD

Original Issue Date

01/17/2017

Effective Date

01/17/2017

Expiration Date

07/31/2017

City

MCHENRY

State

Zip

60050

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020