SHASHWATI PRADHAN 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

Title

First Name

SHASHWATI

Last Name

PRADHAN

Business Name

SHASHWATI PRADHAN MD

Original Issue Date

05/01/2020

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023