MANISHA AMI PATEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

CANCELLED

Business

First Name

MANISHA

Middle

AMI

Last Name

PATEL

Suffix

Business Name

MANISHA AMI PATEL MD

Original Issue Date

04/10/2000

Effective Date

04/10/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006