HARSHIT HARESH MODI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

HARSHIT

Middle

HARESH

Last Name

MODI

Suffix

Business Name

HARSHIT HARESH MODI MD

Original Issue Date

05/07/2010

Effective Date

05/07/2010

Expiration Date

07/31/2011

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011