SHANTU NAGIN PATEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

SHANTU NAGIN

Last Name

PATEL

Suffix

Business Name

SHANTU NAGIN PATEL MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020