JIGNESH P MODI MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049166888

License Status

NOT RENEWED

Business

Title

First Name

JIGNESH

Middle

Last Name

MODI

Business Name

JIGNESH P MODI MD

Original Issue Date

03/20/2006

Effective Date

03/20/2006

Expiration Date

03/31/2007

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/14/2007