MANISH SURENDRA PATEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

CANCELLED

Business

First Name

MANISH

Middle

SURENDRA

Last Name

PATEL

Suffix

Business Name

MANISH SURENDRA PATEL MD

Original Issue Date

06/15/2006

Effective Date

06/15/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008