SHAMITA VASANT BANSORE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

SHAMITA

Middle

VASANT

Last Name

BANSORE

Suffix

Business Name

SHAMITA VASANT BANSORE MD

Original Issue Date

11/07/2002

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023