SHIVALI KANAL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

INOPERATIVE

Business

First Name

SHIVALI

Last Name

KANAL

Business Name

SHIVALI KANAL

Original Issue Date

07/05/2023

Effective Date

02/02/2024

Expiration Date

03/01/2026

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025