SHAILESH P UPADHYAY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

CANCELLED

Business

First Name

SHAILESH P

Last Name

UPADHYAY

Suffix

Business Name

SHAILESH P UPADHYAY MD

Original Issue Date

05/31/2005

Effective Date

05/31/2005

Expiration Date

07/31/2008

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008