KETAN JAYANTIBHAI PATEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

Title

First Name

KETAN

Middle

JAYANTIBHAI

Last Name

PATEL

Business Name

KETAN JAYANTIBHAI PATEL MD

Original Issue Date

09/03/2020

Effective Date

06/26/2023

Expiration Date

07/31/2026

City

WILDWOOD

State

Zip

63005

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/26/2023