VIVEK J GOSWAMI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

VIVEK

Middle

Last Name

GOSWAMI

Business Name

VIVEK J GOSWAMI

Original Issue Date

05/30/2003

Effective Date

05/30/2003

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006