PREM LATA PAUL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048338

License Status

NOT RENEWED

Business

First Name

PREM LATA

Last Name

PAUL

Suffix

Business Name

PREM LATA PAUL MD

Original Issue Date

09/19/1973

Effective Date

06/24/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017