KAVITHA PANCHOLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

KAVITHA

Last Name

PANCHOLY

Business Name

KAVITHA PANCHOLY MD

Original Issue Date

09/11/2012

Effective Date

09/11/2012

Expiration Date

07/31/2014

City

GLENDALE HEIGHTS

State

Zip

60139

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014