FORAM PATEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****76

License Status

NOT RENEWED

Business

First Name

FORAM

Last Name

PATEL

Business Name

FORAM PATEL

Original Issue Date

03/24/2023

Effective Date

03/24/2023

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60613

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025