JUGAL RAJIV THAKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

JUGAL

Middle

RAJIV

Last Name

THAKER

Business Name

JUGAL RAJIV THAKER MD

Original Issue Date

06/29/2023

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023