KANAN MODHWADIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

Title

First Name

KANAN

Last Name

MODHWADIA

Business Name

KANAN MODHWADIA MD

Original Issue Date

01/11/2021

Effective Date

08/09/2023

Expiration Date

07/31/2026

City

WINFIELD

State

Zip

60190

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/09/2023