ATUL TRIVEDI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

ATUL

Last Name

TRIVEDI

Business Name

ATUL TRIVEDI

Original Issue Date

10/17/2003

Effective Date

05/09/2013

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014