SUSHANTH BODA DO - Medical Doctor License in Illinois | # 125071636

SUSHANTH BODA DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071636

License Status

CANCELLED

Business

N

Title

DO

First Name

SUSHANTH

Last Name

BODA

Business Name

SUSHANTH BODA DO

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

03/27/2018