SUSHANT PUNJARAM KALE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

SUSHANT

Middle

PUNJARAM

Last Name

KALE

Suffix

Business Name

SUSHANT PUNJARAM KALE MD

Original Issue Date

05/27/2011

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

FENTON

State

Zip

63026

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021