VIDHI SRIVASTAVA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

Title

First Name

VIDHI

Last Name

SRIVASTAVA

Business Name

VIDHI SRIVASTAVA MD

Original Issue Date

06/02/2017

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

FENTON

State

Zip

63026

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023