KAVITA SRIRANGA PHATAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

KAVITA

Middle

SRIRANGA

Last Name

PHATAK

Suffix

Business Name

KAVITA SRIRANGA PHATAK MD

Original Issue Date

01/18/2008

Effective Date

01/18/2008

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008