VANITA S MODI 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

First Name

VANITA S

Last Name

MODI

Suffix

Business Name

VANITA S MODI MD

Original Issue Date

01/28/1985

Effective Date

01/28/1985

Expiration Date

07/31/1987

City

CLIFTON

State

Zip

60927

County

IROQUOIS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006