SANJAY K KHOLWADWALA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

SANJAY K

Last Name

KHOLWADWALA

Business Name

SANJAY K KHOLWADWALA

Original Issue Date

08/07/1996

Effective Date

08/07/1996

Expiration Date

07/31/1999

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006