MAMATHA ANANTH - Medical Doctor License in Illinois | # 125030202

MAMATHA ANANTH

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030202

License Status

EXPIRED

Business

N

First Name

MAMATHA

Last Name

ANANTH

Business Name

MAMATHA ANANTH

Original Issue Date

06/09/1993

Effective Date

06/09/1993

Expiration Date

06/30/1996

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

09/22/2006