MITESHKUMAR N MODI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002919

License Status

ACTIVE

Business

First Name

MITESHKUMAR

Middle

Last Name

MODI

Business Name

MITESHKUMAR N MODI

Original Issue Date

12/15/2006

Effective Date

01/07/2026

Expiration Date

03/01/2028

City

GLENDALE HEIGHTS

State

Zip

60139

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/07/2026