PRIYANKA SURESH SHASTRI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

PRIYANKA

Middle

SURESH

Last Name

SHASTRI

Business Name

PRIYANKA SURESH SHASTRI DO

Original Issue Date

08/17/2020

Effective Date

07/25/2024

Expiration Date

07/31/2026

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2024