SUSHRUT R PATEL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

SUSHRUT R

Last Name

PATEL

Business Name

SUSHRUT R PATEL

Original Issue Date

07/11/2002

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021