FORAM RAJENDRA DESAI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

Title

First Name

FORAM

Middle

RAJENDRA

Last Name

DESAI

Business Name

FORAM RAJENDRA DESAI MD

Original Issue Date

07/01/2021

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023