SEERIN VIVIANE SHATAVI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

Title

First Name

SEERIN

Middle

VIVIANE

Last Name

SHATAVI

Business Name

SEERIN VIVIANE SHATAVI MD

Original Issue Date

08/05/2010

Effective Date

07/08/2014

Expiration Date

07/31/2017

City

MASON

State

Zip

45040

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020