SHIVANI TUSHAR PATEL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

Title

First Name

SHIVANI

Middle

TUSHAR

Last Name

PATEL

Business Name

SHIVANI TUSHAR PATEL DO

Original Issue Date

06/03/2024

Effective Date

06/03/2024

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2024