HIMANSHU PATHAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

HIMANSHU

Last Name

PATHAK

Business Name

HIMANSHU PATHAK MD

Original Issue Date

04/22/2014

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021