MIRA MODI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

Title

First Name

MIRA

Last Name

MODI

Business Name

MIRA MODI DO

Original Issue Date

09/25/2025

Effective Date

09/25/2025

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/23/2025