JUSTIN PUTHUVELIL ALEXANDER MD - Medical Doctor License in Illinois | # 125077119

JUSTIN PUTHUVELIL ALEXANDER MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077119

License Status

CANCELLED

Business

N

Title

MD

First Name

JUSTIN

Middle

PUTHUVELIL

Last Name

ALEXANDER

Business Name

JUSTIN PUTHUVELIL ALEXANDER MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

State

IL

Specialty/Qualifier

Critical Care Medicine

Ever Disciplined

N

LastModifiedDate

05/09/2020