MITUL BIPINCHANDRA MODI MD 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

MITUL

Middle

BIPINCHANDRA

Last Name

MODI

Business Name

MITUL BIPINCHANDRA MODI MD

Original Issue Date

11/13/2024

Effective Date

11/13/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/13/2024