EKANKA MUKHOPADHYAY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

EKANKA

Last Name

MUKHOPADHYAY

Suffix

Business Name

EKANKA MUKHOPADHYAY MD

Original Issue Date

01/13/2009

Effective Date

08/21/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023