MITESHKUMAR N MODI Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****98

License Status

ACTIVE

Business

First Name

MITESHKUMAR

Middle

Last Name

MODI

Business Name

MITESHKUMAR N MODI

Original Issue Date

12/23/2008

Effective Date

03/24/2026

Expiration Date

03/01/2028

City

SCHILLER PARK

State

Zip

60176

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/24/2026