SHIVAM CHANDRAGUPTA VEDAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

SHIVAM

Middle

CHANDRAGUPTA

Last Name

VEDAK

Business Name

SHIVAM CHANDRAGUPTA VEDAK MD

Original Issue Date

09/26/2022

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023