SHYAM K BHAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

SHYAM

Middle

Last Name

BHAT

Business Name

SHYAM K BHAT MD

Original Issue Date

09/22/2004

Effective Date

06/18/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011