SHIVANI AGRAWAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

Title

First Name

SHIVANI

Last Name

AGRAWAL

Business Name

SHIVANI AGRAWAL MD

Original Issue Date

12/11/2020

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023