VANITA S MODI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069840

License Status

NOT RENEWED

Business

First Name

VANITA S

Last Name

MODI

Suffix

Business Name

VANITA S MODI MD

Original Issue Date

11/16/1984

Effective Date

11/16/1984

Expiration Date

07/31/1987

City

CORONA

State

Zip

11368

County

NEW YORK

Ever Disciplined

LastModifiedDate

09/20/2006