NIDHI SHUKLA 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

NIDHI

Last Name

SHUKLA

Suffix

Business Name

NIDHI SHUKLA MD

Original Issue Date

07/12/2007

Effective Date

07/12/2007

Expiration Date

07/31/2008

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008