SHIVALI DAVE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

ACTIVE

Business

First Name

SHIVALI

Last Name

DAVE

Business Name

SHIVALI DAVE

Original Issue Date

07/19/2017

Effective Date

04/22/2024

Expiration Date

03/01/2026

City

FREEPORT

State

Zip

61032

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025