SHIRISH D DEVASTHALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

SHIRISH D

Last Name

DEVASTHALI

Suffix

Business Name

SHIRISH D DEVASTHALI MD

Original Issue Date

12/17/1985

Effective Date

12/17/1985

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006