EKTA MODI PATEL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

EKTA

Middle

MODI

Last Name

PATEL

Business Name

EKTA MODI PATEL DO

Original Issue Date

09/21/2012

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023