AJAY LAXMANDAS JEETWANI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

AJAY

Middle

LAXMANDAS

Last Name

JEETWANI

Business Name

AJAY LAXMANDAS JEETWANI MD

Original Issue Date

06/25/2012

Effective Date

06/12/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2023