KETAN S PATEL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

CANCELLED

Business

First Name

KETAN S

Last Name

PATEL

Business Name

KETAN S PATEL

Original Issue Date

12/01/1995

Effective Date

12/01/1995

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60012

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006