MITALI GOYAL Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

CANCELLED

Business

First Name

MITALI

Last Name

GOYAL

Business Name

MITALI GOYAL

Original Issue Date

05/19/2003

Effective Date

05/19/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006