SUSHAMA MODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

SUSHAMA

Last Name

MODY

Suffix

Business Name

SUSHAMA MODY MD

Original Issue Date

05/18/2005

Effective Date

05/18/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008