BANSARI S GUJAR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

BANSARI

Middle

Last Name

GUJAR

Business Name

BANSARI S GUJAR

Original Issue Date

06/01/2004

Effective Date

06/01/2004

Expiration Date

07/31/2005

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011