KAVITHA BATHALA - Medical Doctor License in Illinois | # 125040304

KAVITHA BATHALA

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040304

License Status

EXPIRED

Business

N

First Name

KAVITHA

Last Name

BATHALA

Business Name

KAVITHA BATHALA

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

06/23/2002

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006