SMITA VIJAY PATIL 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

SMITA

Middle

VIJAY

Last Name

PATIL

Suffix

Business Name

SMITA VIJAY PATIL MD

Original Issue Date

06/21/2007

Effective Date

06/21/2007

Expiration Date

07/31/2008

City

ALTON

State

Zip

62002

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008