PRABHA BASTIAN RAJAN 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

PRABHA

Middle

BASTIAN

Last Name

RAJAN

Suffix

Business Name

PRABHA BASTIAN RAJAN MD

Original Issue Date

03/14/2003

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023