DIVYESH G MEHTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

CANCELLED

Business

First Name

DIVYESH

Middle

Last Name

MEHTA

Suffix

Business Name

DIVYESH G MEHTA MD

Original Issue Date

10/04/2001

Effective Date

04/13/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014