RAJU AMAREGOUDA PATIL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

CANCELLED

Business

First Name

RAJU

Middle

AMAREGOUDA

Last Name

PATIL

Suffix

Business Name

RAJU AMAREGOUDA PATIL MD

Original Issue Date

07/11/2008

Effective Date

07/11/2008

Expiration Date

07/31/2011

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011