RENUKA N PATEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

RENUKA N

Last Name

PATEL

Suffix

Business Name

RENUKA N PATEL MD

Original Issue Date

06/24/1988

Effective Date

06/24/1988

Expiration Date

07/31/2005

City

GRANITE CITY

State

Zip

62020

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020