GHANSHYAM R PATEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

GHANSHYAM

Middle

Last Name

PATEL

Business Name

GHANSHYAM R PATEL MD

Original Issue Date

06/23/2024

Effective Date

06/23/2024

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/27/2025