SHIVANI GIRISH THAKKAR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

Title

First Name

SHIVANI

Middle

GIRISH

Last Name

THAKKAR

Business Name

SHIVANI GIRISH THAKKAR MD

Original Issue Date

05/07/2015

Effective Date

05/07/2015

Expiration Date

07/31/2017

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017