AMI SUBHAS VAIDYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

Title

First Name

AMI

Middle

SUBHAS

Last Name

VAIDYA

Business Name

AMI SUBHAS VAIDYA MD

Original Issue Date

07/25/2017

Effective Date

07/25/2017

Expiration Date

09/30/2020

City

KANKAKEE

State

Zip

60901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021