MANISH MADHUKAR SHUKLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

First Name

MANISH

Middle

MADHUKAR

Last Name

SHUKLA

Suffix

Business Name

MANISH MADHUKAR SHUKLA MD

Original Issue Date

08/31/1998

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2023