SUJATA M WAGH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

CANCELLED

Business

First Name

SUJATA

Middle

Last Name

WAGH

Suffix

Business Name

SUJATA M WAGH MD

Original Issue Date

11/21/2005

Effective Date

11/21/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008