SHRADDHA G MAHADEVIA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****65

License Status

NOT RENEWED

Business

First Name

SHRADDHA

Middle

Last Name

MAHADEVIA

Business Name

SHRADDHA G MAHADEVIA

Original Issue Date

02/07/2011

Effective Date

02/07/2011

Expiration Date

03/01/2012

City

WINFIELD

State

Zip

60190

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/16/2012