PRIYA SHIRISH BHAKTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

Title

First Name

PRIYA

Middle

SHIRISH

Last Name

BHAKTA

Business Name

PRIYA SHIRISH BHAKTA MD

Original Issue Date

04/07/2023

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023