GIRISH GANESH DESHPANDE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

GIRISH

Middle

GANESH

Last Name

DESHPANDE

Suffix

Business Name

GIRISH GANESH DESHPANDE MD

Original Issue Date

06/18/2003

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/17/2023