SHITAL T MEHTA 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

SHITAL

Middle

Last Name

MEHTA

Business Name

SHITAL T MEHTA

Original Issue Date

02/27/2003

Effective Date

02/27/2003

Expiration Date

07/31/2005

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020