SHIVANI GIRISH THAKKAR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137952

License Status

INACTIVE

Business

Title

First Name

SHIVANI

Middle

GIRISH

Last Name

THAKKAR

Business Name

SHIVANI GIRISH THAKKAR MD

Original Issue Date

05/07/2015

Effective Date

05/07/2015

Expiration Date

07/31/2017

City

WAUWATOSA

State

Zip

53213

Ever Disciplined

LastModifiedDate

07/05/2017