ISHANI SUJATHA ALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

ISHANI

Middle

SUJATHA

Last Name

ALI

Suffix

Business Name

ISHANI SUJATHA ALI MD

Original Issue Date

06/08/2004

Effective Date

08/03/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023