MANAN CHETAN TRIVEDI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

Title

First Name

MANAN

Middle

CHETAN

Last Name

TRIVEDI

Business Name

MANAN CHETAN TRIVEDI MD

Original Issue Date

01/10/2019

Effective Date

01/10/2019

Expiration Date

09/30/2020

City

BLUE ISLAND

State

Zip

60406

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

01/14/2021