ANKITA MODI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

ANKITA

Last Name

MODI

Business Name

ANKITA MODI

Original Issue Date

03/25/2005

Effective Date

03/25/2005

Expiration Date

07/31/2008

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011