SUJATA MADHUKAR SHANBHAG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

SUJATA

Middle

MADHUKAR

Last Name

SHANBHAG

Suffix

Business Name

SUJATA MADHUKAR SHANBHAG MD

Original Issue Date

03/18/2004

Effective Date

03/18/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006