AMIT BAKULESH MEHTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

AMIT

Middle

BAKULESH

Last Name

MEHTA

Suffix

Business Name

AMIT BAKULESH MEHTA MD

Original Issue Date

03/24/2016

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021