SHIVANI M BHATIA Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

CANCELLED

Business

First Name

SHIVANI

Middle

Last Name

BHATIA

Business Name

SHIVANI M BHATIA

Original Issue Date

05/28/2002

Effective Date

05/28/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006