SHIVANI SHANKAR SHINDE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

Title

First Name

SHIVANI

Middle

SHANKAR

Last Name

SHINDE

Business Name

SHIVANI SHANKAR SHINDE MD

Original Issue Date

03/30/2011

Effective Date

07/05/2011

Expiration Date

07/31/2014

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014