POOJA S POTHIWALA 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

POOJA

Middle

Last Name

POTHIWALA

Business Name

POOJA S POTHIWALA MD

Original Issue Date

12/01/2009

Effective Date

05/13/2011

Expiration Date

07/31/2014

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014