PRAJAKTA MOHAN PHATAK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137423

License Status

INACTIVE

Business

Title

First Name

PRAJAKTA

Middle

MOHAN

Last Name

PHATAK

Business Name

PRAJAKTA MOHAN PHATAK MD

Original Issue Date

02/26/2015

Effective Date

04/18/2017

Expiration Date

09/30/2020

City

WASHINGTON

State

Zip

20037

Ever Disciplined

LastModifiedDate

04/05/2020